Dr. Jonathan W Bauter, DDS
Dentist in Boise, ID. Individual provider (NPI-1).
NPI number1013067115
StatusActive
Last updated in NPPESAug 15, 2019
Details
- NPI
- 1013067115
- Entity type
- Individual (NPI-1)
- Name
- Dr. Jonathan W Bauter
- Credential
- DDS
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Jan 11, 2007
- Last updated
- Aug 15, 2019
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 122300000X | Dentist | D-4357 | ID | Yes |
| 122300000X | Dentist | 4714 | NV |
Practice location
210 W Mallard Dr Ste EBoise, ID 83706-3992
Phone 208-344-8363
Mailing address
210 W Mallard Dr Ste EBoise, ID 83706-3992
Phone 208-344-8363
Other practice locations
525 W Washington St
Carson City, NV 89703-3830
Carson City, NV 89703-3830
Phone 775-882-4247
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