NPI 1558440313

Jonathan Ragnar Sander, LD

Practitioner Denturist Buhl, ID

Practice location

Address: 124 11th Avenue North Denture Center, Buhl, ID 83316
Phone: (208) 543-2747
Mailing address: 124 11th Ave N, Buhl, ID 83316-1602

Registered specialties

Denturist Primary

Dental Providers Taxonomy 122400000X Licence LD 36 (ID)

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Registry record

NPI: 1558440313
Entity type: Individual
Sex (as registered): Male
NPI issued: 3 Nov 2006
Record last updated: 27 Nov 2024

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.