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Organization

MOUNTAIN VIEW DENTISTRY

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. ASHLEE BEHLER (SECRETARY)
(208) 983-0105
Entity
Organization

Contact information

Practice address
615 W NORTH ST, GRANGEVILLE, ID 83530-1239
(208) 983-0105
(208) 983-2339
Mailing address
615 W NORTH ST, GRANGEVILLE, ID 83530-1239
(208) 983-0105
(208) 983-2339

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
D3978
ID
1223G0001X
General Practice Dentistry
Primary
D3987
ID

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
807500900
ID
05
807665400
ID
Enumeration date
06/03/2008
Last updated
06/03/2008
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