Eagle Rock Dental Care of Rexburg

NPI #1831213149 in Rexburg, Idaho

Provider Information

NPI Number: 1831213149
Entity Type: Organization
Organization Name: Eagle Rock Dental Care of Rexburg
Primary Specialty: Dentist - General Practice
Enumeration Date: Mar 19, 2007
Last Updated: Mar 6, 2013

Practice Location

Address: 556 TREJO ST STE C
City: Rexburg
State: Idaho
ZIP Code: 83440-2626
Phone: (208) 359-2224

Authorized Official

Name: TRUDEE L CHAPPLE
Title: ADMINISTRATOR
Phone: (208) 359-2224

Specialties & Taxonomy Codes

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

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