Individual
DR. NATHAN RICHARD GEORGE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
7726 LUPINE LANE, VICTOR, ID 83455
(208) 787-8100
Mailing address
PO BOX 487, VICTOR, ID 83455-0487
(208) 787-8100
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D-4352
ID
Other
Enumeration date
04/25/2011
Last updated
04/25/2011
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