| Jeffrey F. Sowle Dds Pa | |
|
601 East Main St Kendrick ID 83537-0160 | |
| (208) 289-3221 | |
| (208) 289-3721 |
| Full Name | Jeffrey F. Sowle Dds Pa |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 601 East Main St, Kendrick, Idaho |
| Authorized Official Name and Position | Jeffrey F. Sowle (PRESIDENT) |
| Authorized Official Contact | 2082893221 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Jeffrey F. Sowle Dds Pa Po Box 160 Kendrick ID 83537-0160 Ph: (208) 289-3221 | Jeffrey F. Sowle Dds Pa 601 East Main St Kendrick ID 83537-0160 Ph: (208) 289-3221 |
| NPI Number | 1790959609 |
|---|---|
| Provider Enumeration Date | 04/22/2008 |
| Last Update Date | 04/22/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1790959609 | NPI | - | NPPES |
| 002462000 | Medicaid | ID | |
| 5037569 | Medicaid | WA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 66D1616 (Idaho) | Primary |