# TDCJEROME PLLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Today's Dental Care
- **Organization subpart:** No

## Provider details

- **NPI number:** 1104229913
- **Authorized official:** DON S WYATT (OWNER)
- **Authorized official phone:** (208) 324-8861

## Contact information

- **Practice address:** 119 COUNTRY LN, JEROME, ID 83338-6147
- **Practice address phone:** (208) 324-8861
- **Practice address fax:** (208) 324-8899
- **Mailing address:** 119 COUNTRY LN, JEROME, ID 83338-6147
- **Mailing address phone:** (208) 324-8861
- **Mailing address fax:** (208) 324-8899

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | D4052 | ID | Yes |

## Other

- **Enumeration date:** 10/07/2014
- **Last updated:** 10/07/2014