Organization
DENTISTRY FOR KIDS PLLC
Active
Other names
Tooth Town
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT D. MCWHORTER D.D.S. (PRESIDENT)
(208) 237-1567
Entity
Organization
Contact information
Practice address
625 E ALAMEDA RD., POCATELLO, ID 83201
(208) 237-1567
(208) 478-5097
Mailing address
625 E ALAMEDA RD., POCATELLO, ID 83201
(208) 237-1567
(208) 478-5097
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
D-3451-PD
ID
1223P0221X
Pediatric Dentistry
D-4186-PD
ID
Other
Enumeration date
02/05/2013
Last updated
02/05/2013
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