Individual
GREGORY E ROMRIELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
675 YELLOWSTONE AVE STE E, POCATELLO, ID 83201-4511
(208) 237-1450
(208) 478-1181
Mailing address
675 YELLOWSTONE AVE STE E, POCATELLO, ID 83201-4511
(208) 237-1450
(208) 478-1181
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
D1538
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0027325
—
ID
01
—
633218
UNITED CONCORDIA
ID
01
—
82049457412002
BLUE CROSS/BLUE SHIELD
UT
Enumeration date
08/18/2006
Last updated
07/08/2007
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