Individual
DR. DANIEL GRANT FREEMAN JEFFERIES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
30410 HIGHWAY 200, PONDERAY, ID 83852-9601
(208) 263-7101
Mailing address
514 JENNY LN, SANDPOINT, ID 83864-6006
(801) 953-7560
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
D-5050
ID
Other
Enumeration date
06/13/2019
Last updated
06/13/2019
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