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1083642722
SHANE DANIEL VANIA
BOISE, ID
NPI
1083642722
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
122300000X Dentist
(Licence: ID D3895)
Enumeration Date
2006-06-29
Last Update Date
2007-09-27
Business Address
Dr. SHANE DANIEL VANIA DDS
900 N LIBERTY ST STE 304
BOISE, ID 83704-8729
Phone number: 208-407-0079
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Mailing Address
Dr. SHANE DANIEL VANIA DDS
304 SUN BURST WAY
BOISE, ID 83709-0661
Phone number:
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