Individual
DR. ROBERT DEE NIELSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
3151 17TH STREET, IDAHO FALLS, ID 83406
(208) 529-3836
Mailing address
695 TIE BREAKER DR, AMMON, ID 83406-4560
(208) 529-3836
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D3698
ID
Other
Enumeration date
11/21/2006
Last updated
07/08/2007
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