Individual
TYLER ROBB
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
715 SW 3RD ST, FRUITLAND, ID 83619-2583
(208) 452-4303
Mailing address
PO BOX 1026, FRUITLAND, ID 83619-1026
(208) 452-4303
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D4158
ID
Other
Enumeration date
06/16/2008
Last updated
06/16/2008
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