| Couch-burtenshaw Dental | |
|
1014 Erikson Dr Rexburg ID 83440-5297 | |
| (208) 359-5454 | |
| (208) 359-0749 |
| Full Name | Couch-burtenshaw Dental |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 1014 Erikson Dr, Rexburg, Idaho |
| Authorized Official Name and Position | Reana Lyn (OFFICE MANAGER) |
| Authorized Official Contact | 2083595454 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Couch-burtenshaw Dental 1014 Erikson Dr Rexburg ID 83440-5297 Ph: (208) 359-5454 | Couch-burtenshaw Dental 1014 Erikson Dr Rexburg ID 83440-5297 Ph: (208) 359-5454 |
| NPI Number | 1770725772 |
|---|---|
| Provider Enumeration Date | 04/06/2009 |
| Last Update Date | 04/06/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1770725772 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | D1303 (Idaho) | Primary |
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