Individual
CORDELL DENTON NEBEKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S., M.S.
Contact information
Practice address
4111 CLOCKTOWER AVE., CALDWELL, ID 83607
(208) 453-6188
Mailing address
4111 CLOCKTOWER AVE., CALDWELL, ID 83607
(208) 453-6188
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
8147013-9923
UT
1223P0221X
Pediatric Dentistry
Primary
D-4483-PD
ID
Other
Enumeration date
01/07/2010
Last updated
03/26/2024
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