Individual
DR. BARRY WAYNE JARDINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.M.D
Contact information
Practice address
1910 S. MERIDAN RD., SUITE 150, MERIDIAN, ID 83642-4842
(208) 888-3540
(208) 888-3930
Mailing address
1910 S MERIDIAN RD, STE 150, MERIDIAN, ID 83642-9061
(208) 888-3540
(208) 888-3930
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D-3807
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8069432
—
ID
Enumeration date
03/13/2007
Last updated
08/31/2016
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