Provider Demographics
NPI:1760556922
Name:FRENCH, JARED TRAVIS (DMD)
Entity Type:Individual
Prefix:
First Name:JARED
Middle Name:TRAVIS
Last Name:FRENCH
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4411 E FLAMINGO AVE
Mailing Address - Street 2:
Mailing Address - City:NAMPA
Mailing Address - State:ID
Mailing Address - Zip Code:83687-3113
Mailing Address - Country:US
Mailing Address - Phone:208-466-3597
Mailing Address - Fax:208-466-8147
Practice Address - Street 1:4411 E FLAMINGO AVE
Practice Address - Street 2:
Practice Address - City:NAMPA
Practice Address - State:ID
Practice Address - Zip Code:83687-3113
Practice Address - Country:US
Practice Address - Phone:208-466-3597
Practice Address - Fax:208-466-8147
Is Sole Proprietor?:No
Enumeration Date:2006-11-20
Last Update Date:2009-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDD3341122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist