Organization
TOWN SQUARE DENTAL PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. NATHAN A CATMULL DDS (OWNER)
(208) 436-4747
Entity
Organization
Contact information
Practice address
502 8TH ST, RUPERT, ID 83350-1417
(208) 436-4747
(208) 436-9683
Mailing address
502 8TH ST, RUPERT, ID 83350-1417
(208) 436-4747
(208) 436-9683
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D4143
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
28443
—
ID
Enumeration date
12/21/2017
Last updated
09/27/2023
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