Organization
EAGLE ROCK DENTAL CARE OF REXBURG
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TRUDEE L CHAPPLE (ADMINISTRATOR)
(208) 359-2224
Entity
Organization
Contact information
Practice address
556 TREJO ST STE C, REXBURG, ID 83440-2626
(208) 359-2224
(208) 359-2250
Mailing address
556 TREJO ST STE C, REXBURG, ID 83440-2626
(208) 359-2224
(208) 359-2250
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
ID
Other
Enumeration date
03/19/2007
Last updated
03/06/2013
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