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1477177566
BRACKEN ROSS BATEMAN
REXBURG, ID
NPI
1477177566
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
1223G0001X Dentist General Practice
(Licence: ID D-5151)
Enumeration Date
2020-06-03
Last Update Date
2020-06-03
Business Address
BRACKEN ROSS BATEMAN DDS
242 E MAIN ST
REXBURG, ID 83440-2022
Phone number: 208-680-7067
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Mailing Address
BRACKEN ROSS BATEMAN DDS
4461 DELOY DR
IDAHO FALLS, ID 83401-1226
Phone number: 208-680-7067
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