Clubhouse Pediatric Dentistry of Jackson
Clubhouse Pediatric Dentistry of Jackson provides Pediatric Dentistry in Jackson Hole, Wyoming. Registered with an NPI since 2018.
- In the registry since
- 2018
Practice location Address checks out
1130 US-89Jackson Hole, WY 83001-8701
Phone: (307) 733-5439
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Pediatric Dentistry (primary) | Taxonomy 1223P0221X |
|---|
Record details
| NPI number | 1942775960 |
|---|---|
| Entity type | Organization (Type 2) |
| Organization subpart | No |
| Authorized official | Courtney Jackson — Pediatric Dentist · (307) 733-5439 |
| NPI enumerated | October 5, 2018 |
| Last updated in NPPES | October 5, 2018 |
| Mailing address | 3210 E 81st S, Idaho Falls, ID 83406-8302 |