Provider Demographics
NPI:1437507233
Name:INTERMOUNTAIN COMPANIES
Entity type:Organization
Organization Name:INTERMOUNTAIN COMPANIES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:GENERAL DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:J
Authorized Official - Last Name:HANDELMAN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS,MBA
Authorized Official - Phone:719-661-0017
Mailing Address - Street 1:7025 E VIA SOLERI DR
Mailing Address - Street 2:#1045
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85251
Mailing Address - Country:US
Mailing Address - Phone:719-661-0017
Mailing Address - Fax:
Practice Address - Street 1:7025 E VIA SOLERI DR
Practice Address - Street 2:#1045
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85251
Practice Address - Country:US
Practice Address - Phone:719-661-0017
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-06-02
Last Update Date:2016-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ9418122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty