Individual
DOUG DAMMROSE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D., D.D.S.
Contact information
Practice address
1918 EVERETT ST, CALDWELL, ID 83605-5052
(208) 331-8846
(208) 331-7344
Mailing address
1918 EVERETT ST, CALDWELL, ID 83605-5052
(208) 331-8846
(208) 331-7344
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
M-4340
ID
Other
Enumeration date
06/22/2007
Last updated
07/08/2007
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