# ROGUE RIVER SLEEP DENTISTRY

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

## Provider details

- **NPI number:** 1669035655
- **Authorized official:** MICHAEL AARON HOLM DDS (DENTIST/OWNER)
- **Authorized official phone:** (206) 818-0492

## Contact information

- **Practice address:** 205 N BERKLEY ST, COUNCIL, ID 83612-5015
- **Practice address phone:** (206) 818-0492
- **Mailing address:** 377 AIRPORT RD, WEISER, ID 83672-5759
- **Mailing address phone:** (206) 818-0492

## Taxonomy

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

## Other

- **Enumeration date:** 04/16/2019
- **Last updated:** 04/16/2019