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DR. NATHAN RICHARD GEORGE D.D.S.

General Practice >> Dentist >> Dental Providers

Registrant NPI Number: 1437440591

Individual Registrant:
DR. NATHAN RICHARD GEORGE D.D.S.
Gender: M
Sole Proprietor

Location and contact information for practice:
7726 LUPINE LANE  VICTOR, ID 83455 US
Tel: 208-787-8100  Fax: --

Contact information for business:
PO BOX 487  VICTOR, ID 83455-0487 US
Tel: 208-787-8100  Fax: --

Registration Information:
NPI: 1437440591
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y1223G0001XDental Providers
Dentist
General Practice
IDD-4352

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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