Mudrow, Kevin Richard

Mudrow, Kevin Richard is an individual health care provider with primary practice located at 333 S Woodruff Ave Suite F, Idaho Falls ID 83401-4322. He recently has only one registered license in Dental Providers / Dentist, which is considered as his primary health care specialty. Mudrow, Kevin Richard can be contacted via phone (208) 524-2030.

Contact Information

Primary practice address
333 S Woodruff Ave Suite F Idaho Falls ID 83401-4322
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Dentist 122300000X D8946 Oregon
Dental Providers / Dentist 122300000X D4481 Idaho

Profile Details

NPI number 1114126992
LBN Legal business name Mudrow, Kevin Richard
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 12th, 2007
Last updated Sep 11th, 2013 - about 13 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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