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1780819516
WILLOW CREEK DENTAL PC
IDAHO FALLS, ID
NPI
1780819516
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Entity Type
Organization
Authorized Contact
BRANDON D GORDON
Dentist
208-552-0919
Organization Subpart ?
No
Primary Taxonomy
261QD0000X Clinic/Center, Dental
(Licence: ID D-4179)
Enumeration Date
2009-05-22
Last Update Date
2009-05-22
Business Address
WILLOW CREEK DENTAL PC
1380 LATAH AVE
IDAHO FALLS, ID 83402
Phone number: 208-552-0919
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Mailing Address
WILLOW CREEK DENTAL PC
PO BOX 50938
IDAHO FALLS, ID 83405-0938
Phone number: 208-552-0919
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