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General NPI Number Information
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NPI Number | 1285715979
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Entity Type | Individual
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Provider Name | JEFFREY B KESLING DDS
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Gender | Male
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Dates
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Enumeration Date | 10/18/2006
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Last Update Date | 12/29/2011
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Provider Practice Location Address
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Address Line | 900 N. LIBERTY STREET SUITE 304
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City | BOISE
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State | ID
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Zip | 83704
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Country | US
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Telephone | 208-344-2747
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Fax | 208-344-0196
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Provider Business Mailing Address
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Address Line | 900 N. LIBERTY STREET SUITE 304
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City | BOISE
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State | ID
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Zip | 83704
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Country | US
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Telephone | 208-344-2747
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Fax | 208-344-0196
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | D3334
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License Number State | ID
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Taxonomy #2
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | D3334
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License Number State | ID
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