INTERMOUNTAIN DENTAL SPECIALISTS

BOISE, ID
NPI1134522535
Entity TypeOrganization
Authorized ContactJERRY MICHAEL CARBONE
Managing Member
208-917-2855
Organization Subpart ?No
Primary Taxonomy261QD0000X Clinic/Center, Dental
(Licence: ID  D3642EN)
Enumeration Date2014-09-30
Last Update Date2014-09-30
Business Address
INTERMOUNTAIN DENTAL SPECIALISTS
12249 W MCMILLAN RD
BOISE, ID 83713-0555
Phone number: 208-917-2855
Mailing Address
INTERMOUNTAIN DENTAL SPECIALISTS
12249 W MCMILLAN RD
BOISE, ID 83713-0555
Phone number: 208-917-2855