Individual
DR. JUSTIN WARD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
2271 OVERLAND AVE, SUITE 4, BURLEY, ID 83318-2960
(208) 678-3265
Mailing address
2271 OVERLAND AVE, SUITE 4, BURLEY, ID 83318-2960
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
D-4510-OR
ID
Other
Enumeration date
07/17/2013
Last updated
07/17/2013
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