Bracken Ross Bateman, DDS

NPI #1477177566 in Rexburg, Idaho

Provider Information

NPI Number: 1477177566
Entity Type: Individual
Name: Bracken Ross Bateman, DDS
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Dentist - General Practice
Credential: DDS
Enumeration Date: Jun 3, 2020
Last Updated: Jun 3, 2020

Practice Location

Address: 242 E MAIN ST
City: Rexburg
State: Idaho
ZIP Code: 83440-2022
Phone: (208) 680-7067

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist - General Practice — General Practice	1223G0001X	Primary

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