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Individual

JEFFREY DAVID IVES

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
222 E CHALAN SANTO PAPA, #304 REFLECTION CENTER, HAGATNA, GU 96910-5161
(671) 472-6824
Mailing address
222 E CHALAN SANTO PAPA, #304 REFLECTION CENTER, HAGATNA, GU 96910-5161
(671) 472-6824
(671) 472-6824

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
D728
GU

Other

Enumeration date
02/27/2012
Last updated
02/27/2012
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