Individual
ELISABETH KATHLEEN GOLTZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
427 12TH STREET, PLUMMER, IDAHO, ID 83851
(208) 686-1931
Mailing address
3670 WINDFALL PASS RD, PLUMMER, ID 83851-6011
(208) 661-1312
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
DH-1771
ID
Other
Enumeration date
10/06/2022
Last updated
10/06/2022
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