| Robert A Ebert, Dds | |
|
910 W Ironwood Dr Coeur D Alene ID 83814-2601 | |
| (208) 664-2912 | |
| Not Available |
| Full Name | Robert A Ebert, Dds |
|---|---|
| Speciality | Dentist |
| Location | 910 W Ironwood Dr, Coeur D Alene, Idaho |
| Authorized Official Name and Position | Robert A Ebert (OWNER) |
| Authorized Official Contact | 2086642912 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Robert A Ebert, Dds 910 W Ironwood Dr Coeur D Alene ID 83814-2601 Ph: (208) 664-2912 | Robert A Ebert, Dds 910 W Ironwood Dr Coeur D Alene ID 83814-2601 Ph: (208) 664-2912 |
| NPI Number | 1467684175 |
|---|---|
| Provider Enumeration Date | 08/13/2009 |
| Last Update Date | 08/13/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1467684175 | NPI | - | NPPES |
| 000283400 | Medicaid | ID | |
| 9200508/181205 | Medicaid | ID |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | (* (Not Available)) | Primary |
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