Organization
DENTAL DEPOT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JESSE COLE DDS (PARTNER)
(208) 882-2531
Entity
Organization
Contact information
Practice address
803 S JEFFERSON ST, SUITE 2, MOSCOW, ID 83843-3096
(208) 882-2531
(208) 882-5701
Mailing address
803 S JEFFERSON ST, SUITE 2, MOSCOW, ID 83843-3096
(208) 882-2531
(208) 882-5701
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D3990
ID
Other
Enumeration date
05/16/2007
Last updated
08/22/2020
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