NPI 1013067115

Jonathan W Bauter, DDS

Practitioner Dentist Boise, ID

Practice location

Address: 210 W Mallard Dr STE E, Boise, ID 83706-3992
Phone: (208) 344-8363

Registered specialties (2)

Dentist Primary

Dental Providers Taxonomy 122300000X Licence D-4357 (ID)

Other Dentist providers in Idaho →

Dentist

Dental Providers Taxonomy 122300000X Licence 4714 (NV)

Registry record

NPI: 1013067115
Entity type: Individual
Sex (as registered): Male
NPI issued: 11 Jan 2007
Record last updated: 15 Aug 2019

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.