Individual
WESTON DEAN KILLPACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
7708 S 8TH W, IDAHO FALLS, ID 83402-5896
(208) 821-2250
Mailing address
7708 S 8TH W, IDAHO FALLS, ID 83402-5896
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D-5524
ID
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/25/2023
Last updated
07/17/2024
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