MEDICARE: DR. ROBERT NEWMAN PERKINS DMD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	D4716	ID

General Provider Information

NPI Number	:	1275619835
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ROBERT NEWMAN PERKINS DMD

Provider Business Mailing Address
First Line	:	15 W 1ST N
Second Line	:
City	:	DOWNEY
State	:	ID
Zip	:	83234-7730
Country	:	US
Telephone Number	:	208-897-5000
Fax Number	:	208-897-5055

Provider Business Practice Location Address
First Line	:	15 W 1ST N
Second Line	:
City	:	DOWNEY
State	:	ID
Zip	:	83234-7730
Country	:	US
Telephone Number	:	208-897-5000
Fax Number	:	208-897-5000

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/27/2006
Last Update Date	:	03/02/2021

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