Jayson Clark D.D.S.

NPI 1659667459 - Dentist - 122300000X

NPI Details
NPI 1659667459
Gender Male
Enumeration Date 06/21/2011
Last Updated 06/21/2011
Entity Type Individual
Active Over 5 years ago
Practice Location
4274 N EAGLE ROAD
BOISE ID, 83713, US
Phone (208) 938-8228
Fax
Business Location
1781 W MILAZZO ST
MERIDIAN ID, 83646-5099, US
Phone (208) 870-3028
Fax
Toxanomy
Taxonomy Code 122300000X
License State Idaho
License Number D-4363
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According to our database, Dr. Jayson Clark D.D.S. NPI is 1659667459, taxonomy code is 122300000X and license number is D-4363, license state is located at Idaho. Jayson Clark D.D.S. physically located at 4274 N Eagle Road, Boise ID, 83713. NPI Number Jayson Clark D.D.S. has the Individual type.

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1659667459 NPI number is provided on an as is basis without warranty of any kind. 1659667459 is maintained by the National Plan & Provider Enumeration System. The contents of Jayson Clark D.D.S. are for informational purposes only.