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1659667459
JAYSON CLARK
BOISE, ID
NPI
1659667459
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
122300000X Dentist
(Licence: ID d-4363)
Enumeration Date
2011-06-21
Last Update Date
2011-06-21
Business Address
Dr. JAYSON CLARK D.D.S.
4274 N EAGLE ROAD
BOISE, ID 83713
Phone number: 208-938-8228
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Mailing Address
Dr. JAYSON CLARK D.D.S.
1781 W MILAZZO ST
MERIDIAN, ID 83646-5099
Phone number: 208-870-3028
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