Individual
DR. DON S WYATT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
138 COUNTRY LN STE 1, JEROME, ID 83338-6147
(208) 324-8861
(208) 324-8899
Mailing address
138 COUNTRY LN STE 1, JEROME, ID 83338-6147
(208) 324-8861
(208) 324-8899
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D-4052
ID
1223G0001X
General Practice Dentistry
D4052
ID
Other
Enumeration date
06/12/2007
Last updated
09/18/2024
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