# E.T. DENTAL LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Complete Dental Care of North Idaho
- **Organization subpart:** No

## Provider details

- **NPI number:** 1154935039
- **Authorized official:** AARON DOLLAHITE (CEO)
- **Authorized official phone:** (208) 699-0022

## Contact information

- **Practice address:** 418 W CAMERON AVE, KELLOGG, ID 83837-2111
- **Practice address phone:** (208) 682-4540
- **Mailing address:** 418 W CAMERON AVE, KELLOGG, ID 83837-2111
- **Mailing address phone:** (208) 682-4540

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | — | NULL | Yes |
| 1223G0001X | General Practice Dentistry | — | — | Yes |

## Other

- **Enumeration date:** 09/08/2020
- **Last updated:** 09/08/2020