Individual
BRAD L OSWALD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
3456 E 17TH ST, SUITE 115, IDAHO FALLS, ID 83406
(208) 522-1234
(208) 522-3246
Mailing address
3456 E 17TH ST, SUITE 115, IDAHO FALLS, ID 83406
(208) 522-1234
(208) 522-3246
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
D3207
ID
Other
Enumeration date
10/04/2006
Last updated
07/08/2007
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