Individual
DR. JETHE ANN ABRAHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.D.S.
Contact information
Practice address
317 W CHERRY LN, MERIDIAN, ID 83642-1608
(208) 489-7077
Mailing address
890 W MELROSE ST, BOISE, ID 83706-4677
(612) 310-1997
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
D-4270
ID
Other
Enumeration date
09/25/2007
Last updated
05/20/2010
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