Organization
SUMMIT VIEW DENTAL SERVICES PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRENT CHARLES GOLDTHORPE D.M.D. (OWNER/PRESIDENT)
(406) 846-1586
Entity
Organization
Contact information
Practice address
211 E CUSTER ST, MACKAY, ID 83251
(208) 588-3316
(208) 588-3316
Mailing address
PO BOX 86, MACKAY, ID 83251-0086
(208) 588-3316
(208) 588-3316
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
D-4080
ID
261QD0000X
Dental Clinic/Center
D-4080
ID
Other
Enumeration date
05/21/2013
Last updated
05/21/2013
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