Individual
DR. RODMAN OWEN EMORY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
13014 W PERSIMMON LN, BOISE, ID 83713-1986
(208) 377-2072
(208) 376-7580
Mailing address
13014 W PERSIMMON LN, BOISE, ID 83713-1986
(208) 377-2072
(208) 376-7580
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
D1703
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
002697900
—
ID
Enumeration date
04/12/2006
Last updated
10/09/2012
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