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Individual

JEFF YBARGUEN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DDS

Contact information

Practice address
3423 MERLIN DR STE 100, IDAHO FALLS, ID 83404-7430
(208) 542-9900
Mailing address
3423 MERLIN DR # 100, IDAHO FALLS, ID 83404-7430
(208) 542-9900

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
205755965
ID
1223G0001X
General Practice Dentistry
205755965
ID

Other

Enumeration date
09/01/2010
Last updated
09/01/2010
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