KEVIN RICHARD MUDROW

IDAHO FALLS, ID
NPI1114126992
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy122300000X Dentist
(Licence: ID  D4481)
Additional Taxonomies122300000X Dentist
(Licence: OR  D8946)
Enumeration Date2007-07-12
Last Update Date2013-09-11
Business Address
-- KEVIN RICHARD MUDROW D.D.S.
333 S WOODRUFF AVE SUITE F
IDAHO FALLS, ID 83401-4322
Phone number: 208-524-2030
Mailing Address
-- KEVIN RICHARD MUDROW D.D.S.
333 S WOODRUFF AVE SUITE F
IDAHO FALLS, ID 83401-4322
Phone number: 208-524-2030
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