Organization
TDCJEROME PLLC
Active
Other names
Today's Dental Care
Organization subpart
No
Provider details
NPI number
Authorized official
DON S WYATT (OWNER)
(208) 324-8861
Entity
Organization
Contact information
Practice address
119 COUNTRY LN, JEROME, ID 83338-6147
(208) 324-8861
(208) 324-8899
Mailing address
119 COUNTRY LN, JEROME, ID 83338-6147
(208) 324-8861
(208) 324-8899
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D4052
ID
Other
Enumeration date
10/07/2014
Last updated
10/07/2014
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