Organization
JS DENTAL PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JONATHAN SCOTT DMD (PRESIDENT)
(702) 306-1494
Entity
Organization
Contact information
Practice address
110 E USTICK RD, MERIDIAN, ID 83646-5502
(208) 495-3146
(208) 888-6115
Mailing address
110 E USTICK RD, MERIDIAN, ID 83646-5502
(208) 495-3146
(208) 888-6115
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
D4145
ID
Other
Enumeration date
03/17/2016
Last updated
03/17/2016
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