WILLOW CREEK DENTAL PC

IDAHO FALLS, ID
NPI1780819516
Entity TypeOrganization
Authorized ContactBRANDON D GORDON
Dentist
208-552-0919
Organization Subpart ?No
Primary Taxonomy261QD0000X Clinic/Center, Dental
(Licence: ID  D-4179)
Enumeration Date2009-05-22
Last Update Date2009-05-22
Business Address
WILLOW CREEK DENTAL PC
1380 LATAH AVE
IDAHO FALLS, ID 83402
Phone number: 208-552-0919
Mailing Address
WILLOW CREEK DENTAL PC
PO BOX 50938
IDAHO FALLS, ID 83405-0938
Phone number: 208-552-0919
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