Jay Clayton Hansen II, DDS

NPI #1609129519 in Moscow, Idaho

Provider Information

NPI Number: 1609129519
Entity Type: Individual
Name: Jay Clayton Hansen II, DDS
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Dentist
Credential: DDS
Enumeration Date: Oct 17, 2012
Last Updated: Oct 17, 2012

Practice Location

Address: 1526 S LEVICK ST
City: Moscow
State: Idaho
ZIP Code: 83843-2560
Phone: (208) 882-4923

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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