Individual
MONTE ROSCOE EPPICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
205 N BERKLEY ST, COUNCIL, ID 83612-0428
(208) 253-4242
(208) 253-6849
Mailing address
PO BOX 428, COUNCIL, ID 83612-0428
(208) 253-4242
(208) 253-6849
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D3548
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000010152980
BLUE SHIELD
ID
01
—
60498
BLUE CROSS
ID
Enumeration date
03/18/2008
Last updated
03/18/2008
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