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Mr. Jonathan Ragnar Sander, LD
Denturist in Buhl, Idaho
NPI 1558440313

Jonathan Ragnar Sander is a Denturist based in Buhl, ID. Jonathan Ragnar Sander practices in Buhl, ID and has the professional credentials of LD. The NPI Number for Jonathan Ragnar Sander is 1558440313 and holds a License No. LD 36 (Idaho).

The current practice location address for Jonathan Ragnar Sander is 124 11Th Avenue North, Buhl, ID and can be reached out via phone at 208-543-2747.

Location: 124 11Th Avenue North, Buhl, ID, 83316-1602
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1558440313
Provider Name
Jonathan Ragnar Sander
Credential
LD
Provider Entity Type
Individual
Gender
Male
Address
124 11Th Avenue North, Buhl, ID, 83316-1602
Phone Number
208-543-2747
Fax Number
Provider Enumeration Date
11/03/2006
Last Update Date
12/14/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
806630800 05 ID
institution
Provider Business Practice Location Address Details
Address
124 11Th Avenue North
City
Buhl
State
Idaho
Zip
83316
Phone Number
208-543-2747
Fax Number
person
Provider Business Mailing Address Details
Address
124 11Th Avenue North
City
Buhl
State
Idaho
Zip
83316
Phone Number
208-543-2747
Fax Number
person
Provider's Taxonomy Details 1
Type
Dental Providers
Classification
Denturist
Speciality
-
Taxonomy
122400000X
License No.
LD 36 (Idaho)
Definition
Definition to come.
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