Alligator Orthodontics, LLC

Organization Active NPI Orthodontics and Dentofacial Orthopedics Dentistry · Ammon, ID

NPI 1992553499 · NPPES record last updated May 9, 2024

Key facts

NPI
1992553499
Entity type
Organization (NPI type 2)
Primary specialty
Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X
Legal business name
ALLIGATOR ORTHODONTICS, LLC
Practice address
2805 Eagle Dr
Ammon, ID 83406-5769
Phone
(208) 542-1333
NPI assigned
May 9, 2024
Organization subpart
No

Authorized official

Name
Dr. Anthony Mongillo, DMD
Title
Manager
Phone
(208) 542-1333

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

National Provider Directory

Locations

2805 Eagle Dr
Ammon, ID 83406
Phone (208) 542-1333

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Dentistry
Group: 193200000X MULTI-SPECIALTY GROUP
1223P0221X
Orthodontics and Dentofacial Orthopedics Dentistry
Group: 193200000X MULTI-SPECIALTY GROUP
1223X0400X Yes

Addresses

Primary practice location

2805 Eagle Dr
Ammon, ID 83406-5769

Mailing address

2805 Eagle Dr
Ammon, ID 83406-5769
Phone (208) 542-1333

Other providers in Ammon, ID

All providers in Ammon, ID · Orthodontics and Dentofacial Orthopedics Dentistry in Idaho

Sources for this page

Verify at the official NPI Registry.