Organization
E.T. DENTAL LLC
Active
Other names
Complete Dental Care of North Idaho
Organization subpart
No
Provider details
NPI number
Authorized official
AARON DOLLAHITE (CEO)
(208) 699-0022
Entity
Organization
Contact information
Practice address
418 W CAMERON AVE, KELLOGG, ID 83837-2111
(208) 682-4540
Mailing address
418 W CAMERON AVE, KELLOGG, ID 83837-2111
(208) 682-4540
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
09/08/2020
Last updated
09/08/2020
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