| NPI | 1013274661 |
|---|---|
| Former Legal Business Name | BOISE ORAL AND FACIAL SURGERY |
| Entity Type | Organization |
| Authorized Contact | COLE W ANDERSON Owner 208-861-1689 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery |
| Additional Taxonomies | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: ID D4410) |
| Enumeration Date | 2012-04-20 |
| Last Update Date | 2017-09-06 |