Individual
DR. KEVIN S BAUER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
345 N 2ND E STE 3, REXBURG, ID 83440-1603
(208) 390-0109
Mailing address
345 N 2ND E STE 3, REXBURG, ID 83440-1603
(208) 390-0109
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
D-1824
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001298400
—
ID
Enumeration date
03/27/2007
Last updated
08/27/2024
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