Individual
JEFFREY T MCMINN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
625 E ALAMEDA RD, POCATELLO, ID 83201-3622
(208) 237-0005
(208) 237-7982
Mailing address
625 E ALAMEDA RD, POCATELLO, ID 83201-3622
(208) 237-0005
(208) 237-7982
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
D-3774-OR
ID
Other
Enumeration date
04/12/2007
Last updated
07/08/2007
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