Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223D0001X | Dental Public Health | 55805 | CA |
NPI | 1235153099 |
---|---|
Provider Name | Robert Daniel Kifer |
First Address | New Town, ND 58763-9112 |
Second Address | New Town, ND 58763-9112 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/07/2006 |
Last Update Date | 31/07/2014 |