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1972719839
MICHAEL DEAN DICKENS
BOISE, ID
NPI
1972719839
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
183500000X Pharmacist
(Licence: ID P4854)
Enumeration Date
2007-05-15
Last Update Date
2007-07-08
Business Address
-- MICHAEL DEAN DICKENS R.PH.
190 E BANNOCK ST
BOISE, ID 83712-6241
Phone number: 208-381-2490
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Mailing Address
-- MICHAEL DEAN DICKENS R.PH.
3876 TATTENHAM AVE
BOISE, ID 83713-3657
Phone number: 208-381-2490
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