Organization
MOUNTAIN HOME DENTAL PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JARED SEXAUER DMD (DENTIST)
(208) 599-3189
Entity
Organization
Contact information
Practice address
455 N 3RD E, MOUNTAIN HOME, ID 83647
(208) 587-2625
Mailing address
685 N 4TH E, MOUNTAIN HOME, ID 83647-2134
(208) 599-3189
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
10/04/2019
Last updated
01/21/2020
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