BRACKEN ROSS BATEMAN

REXBURG, ID
NPI1477177566
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy1223G0001X Dentist General Practice
(Licence: ID  D-5151)
Enumeration Date2020-06-03
Last Update Date2020-06-03
Business Address
BRACKEN ROSS BATEMAN DDS
242 E MAIN ST
REXBURG, ID 83440-2022
Phone number: 208-680-7067
Mailing Address
BRACKEN ROSS BATEMAN DDS
4461 DELOY DR
IDAHO FALLS, ID 83401-1226
Phone number: 208-680-7067