Organization
MONTE PAGE FAMILY DENTISTRY
Active
Other names
Smiles by Design
Organization subpart
No
Provider details
NPI number
Authorized official
RICHARD LAMONTE PAGE D.M.D. (PRESIDENT)
(208) 237-6453
Entity
Organization
Contact information
Practice address
135 WARREN AVE, POCATELLO, ID 83201-4621
(208) 237-6453
(208) 233-4227
Mailing address
135 WARREN AVE, POCATELLO, ID 83201-4621
(208) 237-6453
(208) 233-4227
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D3606
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
806402100
—
ID
Enumeration date
10/12/2006
Last updated
09/17/2008
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