RIVERSIDE DENTAL PC

BLACKFOOT, ID
NPI1053321885
Entity TypeOrganization
Authorized ContactBRADFORD WILLIAM HARPER
Owner/President
208-785-0878
Organization Subpart ?No
Primary Taxonomy122300000X Dentist
(Licence: ID  d3225)
Enumeration Date2006-08-08
Last Update Date2008-07-30
Business Address
RIVERSIDE DENTAL PC
1120 PARKWAY DR
BLACKFOOT, ID 83221
Phone number: 208-785-0878
Mailing Address
RIVERSIDE DENTAL PC
1120 PARKWAY DR
BLACKFOOT, ID 83221
Phone number: 208-785-0878