Organization
BEAR LAKE DENTAL CARE, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LINDA K TIMOTHY (BUSINESS MANAGER)
(208) 847-0153
Entity
Organization
Contact information
Practice address
215 S 4TH ST, MONTPELIER, ID 83254-1591
(208) 847-0153
(208) 847-2938
Mailing address
215 S 4TH ST, PO BOX 326, MONTPELIER, ID 83254-1591
(208) 847-0153
(208) 847-2938
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
08/19/2006
Last updated
08/22/2020
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