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Individual

DR. TERRY TOBIAS DEVORE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.D.S.

Contact information

Practice address
6070 W. JACKSON STREET, SPIRIT LAKE, ID 83869
(208) 623-6400
(208) 623-6464
Mailing address
PO BOX 1389, SPIRIT LAKE, ID 83869-1389
(208) 623-6400
(208) 623-6464

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
8168
KY
122300000X
Dentist
Primary
D-3702
ID

Other

Enumeration date
09/03/2006
Last updated
03/12/2024
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