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Organization

KEVIN MUDROW DDS PLLC

Active
Other names
Mudrow Family Dental
Organization subpart
No

Provider details

NPI number
Authorized official
DR. KEVIN RICHARD MUDROW DDS (OWNER/GENERAL DENTIST)
(208) 524-2036
Entity
Organization

Contact information

Practice address
333 S WOODRUFF AVE, IDAHO FALLS, ID 83401-4322
(208) 524-2036
Mailing address
333 S WOODRUFF AVE, IDAHO FALLS, ID 83401
(208) 524-2036

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary

Other

Enumeration date
09/24/2013
Last updated
09/24/2013
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