Individual
DR. LAVELL PORTER ROBINSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
4274 N EAGLE RD, BOISE, ID 83713-0726
(208) 994-5922
Mailing address
3706 E FLORENCE DR, MERIDIAN, ID 83642-6048
(208) 954-6000
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
D-5070
ID
Other
Enumeration date
07/02/2019
Last updated
07/02/2019
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