| Kyle James Siemen, D.m.d., P.a. | |
|
333 W Cedar St Pocatello ID 83201-5045 | |
| (208) 233-6912 | |
| (208) 233-6921 |
| Full Name | Kyle James Siemen, D.m.d., P.a. |
|---|---|
| Speciality | Dentist |
| Location | 333 W Cedar St, Pocatello, Idaho |
| Authorized Official Name and Position | Kyle James Siemen (DENTIST/PRESIDENT) |
| Authorized Official Contact | 2082336912 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Kyle James Siemen, D.m.d., P.a. 333 W Cedar St Pocatello ID 83201-5045 Ph: (208) 233-6912 | Kyle James Siemen, D.m.d., P.a. 333 W Cedar St Pocatello ID 83201-5045 Ph: (208) 233-6912 |
| NPI Number | 1285044529 |
|---|---|
| Provider Enumeration Date | 05/07/2014 |
| Last Update Date | 05/07/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1285044529 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | D3403 (Idaho) | Primary |
| 332BC3200X | Durable Medical Equipment & Medical Supplies - Customized Equipment | (* (Not Available)) | Secondary |
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