Individual
JAKOB RODGERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
12190 W EVELY PINES LN, STAR, ID 83669-6126
(208) 996-3003
Mailing address
12190 W EVELY PINES LN, STAR, ID 83669-6126
(208) 996-3003
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
D-5406
ID
Other
Enumeration date
05/24/2022
Last updated
09/08/2024
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