Individual
DR. JERRY KEVIN COLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
305 W IDAHO ST, BOISE, ID 83702
(208) 343-7271
(208) 343-7271
Mailing address
305 W IDAHO ST, BOISE, ID 83702
(208) 343-7271
(208) 343-6041
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
D3034
ID
Other
Enumeration date
05/02/2007
Last updated
07/08/2007
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