Organization
OAK MOUNTAIN DENTAL PLLC
Active
Other names
JAKE R RICHARDS DDS, PLLC
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JAKE R RICHARDS DDS (DENTIST)
(208) 237-6453
Entity
Organization
Contact information
Practice address
135 WARREN AVE, POCATELLO, ID 83201-4621
(208) 237-6453
(208) 233-4227
Mailing address
135 WARREN AVE, POCATELLO, ID 83201-4621
(208) 237-6453
(208) 233-4227
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
D-4484
ID
Other
Enumeration date
05/09/2013
Last updated
09/24/2021
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