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Organization
EAGLE RIVER DENTISTRY
Active
Organization
EAGLE RIVER DENTISTRY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BROOKS JOSEPH UNIAT D.D.S. (OWNER)
(208) 938-0280
Entity
Organization
Contact information
Practice address
325 E SHORE DR, SUITE 100, EAGLE, ID 83616-6583
(208) 938-0280
Mailing address
325 E SHORE DR, SUITE 100, EAGLE, ID 83616-6583
(208) 938-0280
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
D-3666
ID
Other
Enumeration date
06/02/2008
Last updated
06/02/2008
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