Organization
INTERMOUNTAIN DENTAL, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARK EDWARD DUKE DMD (PRESIDENT)
(208) 448-1241
Entity
Organization
Contact information
Practice address
103 MAIN ST, PRIEST RIVER, ID 83856-8385
(208) 448-1241
(208) 448-1242
Mailing address
519 JENNY LN, SANDPOINT, ID 83864-6006
(208) 448-1241
(208) 448-1242
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
02/19/2021
Last updated
02/19/2021
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