Individual
DR. KYLE JAMES SIEMEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
333 W CEDAR ST, POCATELLO, ID 83201-5045
(208) 233-6912
(208) 233-6921
Mailing address
4653 MOUNTAIN PARK RD, POCATELLO, ID 83202-1702
(208) 478-8705
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D-3403
ID
Other
Enumeration date
08/09/2006
Last updated
07/08/2007
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