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Organization
KEVIN MUDROW DDS PLLC
Active
Organization
KEVIN MUDROW DDS PLLC
Active
Other names
Mudrow Family Dental
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KEVIN RICHARD MUDROW DDS (OWNER/GENERAL DENTIST)
(208) 524-2036
Entity
Organization
Contact information
Practice address
333 S WOODRUFF AVE, IDAHO FALLS, ID 83401-4322
(208) 524-2036
Mailing address
333 S WOODRUFF AVE, IDAHO FALLS, ID 83401
(208) 524-2036
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
Other
Enumeration date
09/24/2013
Last updated
09/24/2013
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