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1063515062
MARK ASAEL TALL
IDAHO FALLS, ID
NPI
1063515062
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
1223G0001X Dentist, General Practice
(Licence: ID D2018)
Enumeration Date
2006-09-06
Last Update Date
2007-07-08
Business Address
-- MARK ASAEL TALL DDS
2460 E 25TH ST
IDAHO FALLS, ID 83404
Phone number: 208-525-4780
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Mailing Address
-- MARK ASAEL TALL DDS
5600 SOLITUDE LN
IDAHO FALLS, ID 83406
Phone number: 208-524-4242
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