Individual
DR. WILLIAM GUY JEPPE JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
115 SOUTH MAIN, HOMEDALE, ID 83628
(208) 337-4383
(208) 337-5715
Mailing address
PO BOX 1170, HOMEDALE, ID 83628
(208) 337-4383
(208) 337-5715
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D-1675
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
66944
BLUE CROSS
ID
Enumeration date
10/04/2006
Last updated
07/08/2007
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