| Jonathan W Bauter Dds Pllc | |
|
210 W Mallard Dr Suite E Boise ID 83706-6642 | |
| (208) 344-8363 | |
| (208) 345-9590 |
| Full Name | Jonathan W Bauter Dds Pllc |
|---|---|
| Speciality | Dentist |
| Location | 210 W Mallard Dr, Boise, Idaho |
| Authorized Official Name and Position | Jonathan W Bauter (PRESIDENT) |
| Authorized Official Contact | 2083448363 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Jonathan W Bauter Dds Pllc 210 W Mallard Dr Suite E Boise ID 83706-6642 Ph: (208) 344-8363 | Jonathan W Bauter Dds Pllc 210 W Mallard Dr Suite E Boise ID 83706-6642 Ph: (208) 344-8363 |
| NPI Number | 1427302843 |
|---|---|
| Provider Enumeration Date | 11/07/2012 |
| Last Update Date | 11/07/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1427302843 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | D4357 (Idaho) | Primary |
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