Most Relevant Information
Provider Data
| NPI Number: | 1003295999 |
| Provider Name: | JESSICA ANN BERNOTSKI RDH |
| Entity Type: | Individual |
| Taxonomy Code: | 124Q00000X |
| Specialty: | Dental Hygienist |
| License Number: | 5368500-9920 |
Most Important Dates
| Enumeration Date: | 05/25/2015 |
| Last Updated: | 05/25/2015 |
Provider Practice Location
500 W FORT ST
BOISE
ID
837024501
Practice Location Phone/Fax
| Phone: | 2084221000 |
| Fax: |
Provider Mailing Location
500 W FORT ST
BOISE
ID
837024501
Provider Mailing Phone/Fax
| Phone: | 2084221000 |
| Fax: |