Organization
JEFFREY W BOWMAN DMD PC
Active
Other names
Grand Teton Denteal Care
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JEFFREY WILDAN BOWMAN DMD (OWNER - DENTIST)
(208) 787-2323
Entity
Organization
Contact information
Practice address
741 S 50 W, SUITE A, VICTOR, ID 83455-5345
(208) 787-2323
Mailing address
741 S 50 W, SUITE A, VICTOR, ID 83455-5345
(208) 787-2323
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D3162
ID
Other
Enumeration date
06/18/2008
Last updated
06/18/2008
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