Organization
IDAHO ORTHODONTIC-BURLEY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JEFFREY TODD MCMINN DMD (ORTHODONTIST)
(208) 678-2738
Entity
Organization
Contact information
Practice address
1408 POMERELLE AVE, SUITE E, BURLEY, ID 83318-2067
(208) 678-2738
(208) 378-2731
Mailing address
1408 POMERELLE AVE, SUITE E, BURLEY, ID 83318-2067
(208) 678-2738
(208) 378-2731
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
—
—
Other
Enumeration date
03/11/2013
Last updated
03/11/2013
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