# SUMMIT VIEW DENTAL SERVICES PLLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1265878995
- **Authorized official:** DR. BRENT CHARLES GOLDTHORPE D.M.D. (OWNER/PRESIDENT)
- **Authorized official phone:** (406) 846-1586

## Contact information

- **Practice address:** 211 E CUSTER ST, MACKAY, ID 83251
- **Practice address phone:** (208) 588-3316
- **Practice address fax:** (208) 588-3316
- **Mailing address:** PO BOX 86, MACKAY, ID 83251-0086
- **Mailing address phone:** (208) 588-3316
- **Mailing address fax:** (208) 588-3316

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | D-4080 | ID | Yes |
| 261QD0000X | Dental Clinic/Center | D-4080 | ID | — |

## Other

- **Enumeration date:** 05/21/2013
- **Last updated:** 05/21/2013