Individual
JARED WORTHINGTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
621 JENSEN GROVE DR, BLACKFOOT, ID 83221-1685
(435) 668-9919
Mailing address
621 JENSEN GROVE DR, BLACKFOOT, ID 83221-1685
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
9671742
ID
1223P0221X
Pediatric Dentistry
Primary
9671742
ID
Other
Enumeration date
05/21/2021
Last updated
06/28/2025
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