Mongillo, Anthony

Mongillo, Anthony is an individual health care provider with primary practice located at 250 S Skyline Dr Ste 4 , Idaho Falls ID 83402-3292. He recently has 2 registered licenses in different health care specialties including Dental Providers / Orthodontics and Dentofacial Orthopedics, Dental Providers / Dentist. Dental Providers / Orthodontics and Dentofacial Orthopedics is his primary health care specialty. Mongillo, Anthony can be contacted via phone (208) 524-1404.

Contact Information

Primary practice address
250 S Skyline Dr Ste 4 Idaho Falls ID 83402-3292
Phone: (208) 524-1404
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Orthodontics and Dentofacial Orthopedics 1223X0400X 1569 Wyoming
Dental Providers / Orthodontics and Dentofacial Orthopedics 1223X0400X D-4708-OR Idaho
Dental Providers / Dentist 122300000X 2014017950 Missouri

Profile Details

NPI number 1669886982
LBN Legal business name Mongillo, Anthony
Credentials D.M.D, M.S.
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 13th, 2014
Last updated May 9th, 2024 - about last year

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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