Individual
ANTHONY EWELL-KOLLMANN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
90 HOPE DR, MOUNTAIN HOME AFB, ID 83648-1057
(208) 828-7355
Mailing address
7015 IMLAY LOOP, MOUNTAIN HOME AFB, ID 83648-4801
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
34647
TX
Other
Enumeration date
09/24/2018
Last updated
09/26/2022
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