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Individual

JULIA KREK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
921 S 8TH AVE STOP 8088, POCATELLO, ID 83209-0002
(208) 282-2150
Mailing address
2001 BIRDIE THOMPSON DR APT 503, POCATELLO, ID 83201-2771
(208) 282-2150

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
D-5174
ID

Other

Enumeration date
07/21/2020
Last updated
07/21/2020
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