NPI 1063560175

Ron D Sheppard, DDS

Practitioner General Practice Dentistry Idaho Falls, ID

Practice location

Address: 2300 E 17th St, Idaho Falls, ID 83404-6504
Phone: (208) 525-8383
Fax: (208) 523-6419
Mailing address: PO Box 2046, Idaho Falls, ID 83403-2046

Registered specialties

General Practice Dentistry Primary

Dental Providers Taxonomy 1223G0001X Licence D-1542 (ID)

Other Dentist providers in Idaho →

Registry record

NPI: 1063560175
Entity type: Individual
Sex (as registered): Male
NPI issued: 8 Jan 2007
Record last updated: 8 Jul 2007

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.