| NPI | 1861837478 |
|---|---|
| Former Legal Business Name | JAKE R RICHARDS DDS, PLLC |
| Entity Type | Organization |
| Authorized Contact | JAKE R RICHARDS Dentist 208-237-6453 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: ID D-4484) |
| Enumeration Date | 2013-05-09 |
| Last Update Date | 2021-09-24 |