Individual
DR. JEREMY ALAN CHATFIELD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
8152 N WAYNE BLVD, HAYDEN, ID 83835-5031
(208) 500-3030
Mailing address
8152 N WAYNE BLVD, HAYDEN, ID 83835-5031
(208) 500-3030
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
D-5004
ID
1223G0001X
General Practice Dentistry
52352
CA
Other
Enumeration date
10/16/2006
Last updated
06/11/2020
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