RICHARD RUSSELL BURT

BLACKFOOT, ID
NPI1700894771
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy122300000X Dentist
(Licence: ID  D1995)
Enumeration Date2006-08-04
Last Update Date2007-07-08
Business Address
Dr. RICHARD RUSSELL BURT DDS
310 W IDAHO ST
BLACKFOOT, ID 83221-0248
Phone number: 208-785-2255
Mailing Address
Dr. RICHARD RUSSELL BURT DDS
PO BOX 248
BLACKFOOT, ID 83221-0248
Phone number: 208-785-2255
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