Individual
DR. JONATHAN W BAUTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
210 W MALLARD DR STE E, BOISE, ID 83706-3992
(208) 344-8363
Mailing address
210 W MALLARD DR STE E, BOISE, ID 83706-3992
(208) 344-8363
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
4714
NV
122300000X
Dentist
Primary
D-4357
ID
Other
Enumeration date
01/11/2007
Last updated
08/15/2019
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