Individual
MR. JEFFREY ALAN KOLLMANN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LD
Contact information
Practice address
1120 12TH AVENUE SOUTH, NAMPA DENTURE CLINIC, NAMPA, ID 83651
(208) 467-1107
Mailing address
1120 12TH AVENUE SOUTH, NAMPA DENTURE CLINIC, NAMPA, ID 83651
(208) 467-1107
Taxonomy
Speciality
Code
Description
License number
State
122400000X
Denturist
Primary
LD23
ID
Other
Enumeration date
01/31/2008
Last updated
01/31/2008
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