Individual
DR. LARRY J KEMP
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
1541 E CLARK ST, POCATELLO, ID 83201-4100
(208) 232-6400
(208) 232-6050
Mailing address
1541 E CLARK ST, POCATELLO, ID 83201-4100
(208) 232-6400
(208) 232-6050
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D-1783
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0025307
—
ID
Enumeration date
09/14/2006
Last updated
07/09/2007
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