Individual
RICHARD LEE GEORGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
1046 WALLEN RD, MOSCOW, ID 83843-8458
(208) 882-4990
(208) 882-4990
Mailing address
1046 WALLEN RD, MOSCOW, ID 83843-8458
(208) 882-4990
(208) 882-4990
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
D1590
ID
Other
Enumeration date
12/11/2006
Last updated
07/08/2007
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