Organization
ROBERT A EBERT, DDS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ROBERT A EBERT DDS (OWNER)
(208) 664-2912
Entity
Organization
Contact information
Practice address
910 W IRONWOOD DR, COEUR D ALENE, ID 83814-2601
(208) 664-2912
Mailing address
910 W IRONWOOD DR, COEUR D ALENE, ID 83814-2601
(208) 664-2912
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000283400
—
ID
05
—
9200508/181205
—
ID
Enumeration date
08/13/2009
Last updated
08/13/2009
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