-- JAY CLAYTON HANSEN II DDS
Individual Provider (NPI-1)
Active
Dentist
Provider Information
- NPI Number
1609129519- Provider Type
- Individual Provider (NPI-1)
- Credentials
- DDS
- Status
- Active
Contact & Location
- Address
- 1526 S LEVICK ST, MOSCOW, ID, 838432560
- Phone
- (208) 882-4923
- Fax
- (208) 882-8418
Specialties & Taxonomies
Dentist
Primary License: ID #D3853