Individual
ROBERT ACKERMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
10200 W EMERALD ST, SUITE 105, BOISE, ID 83704-8900
(208) 376-7954
Mailing address
1003 E CLEARVUE CT, EAGLE, ID 83616-6460
(208) 884-3934
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
3088
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3088
LICENSE #
ID
01
—
82-0499472
TAX ID #
ID
Enumeration date
01/02/2007
Last updated
07/05/2023
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