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Organization
E.T. DENTAL LLC
Active
Organization
E.T. DENTAL LLC
Active
Other names
Complete Dental Care of North Idaho
Organization subpart
No
Provider details
NPI number
Authorized official
AARON DOLLAHITE (CEO)
(208) 699-0022
Entity
Organization
Contact information
Practice address
418 W CAMERON AVE, KELLOGG, ID 83837-2111
(208) 682-4540
Mailing address
418 W CAMERON AVE, KELLOGG, ID 83837-2111
(208) 682-4540
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
NULL
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
09/08/2020
Last updated
09/08/2020
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