Individual
DR. CON H ANNEST
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
529 SOUTH BROADWAY, BUHL, ID 83316
(208) 543-6511
Mailing address
529 SOUTH BROADWAY, BUHL, ID 83316
(208) 543-6511
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
66D1460
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
64915
BLUE CROSS ID
ID
Enumeration date
08/27/2006
Last updated
07/08/2007
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