| NPI | 1235747338 |
|---|---|
| Doing Business As | DENTISTS OF BOISE AND ORTHODONTICS |
| Entity Type | Organization |
| Authorized Contact | KEVIN JOHNSON Owner 208-258-7740 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice |
| Enumeration Date | 2020-07-15 |
| Last Update Date | 2022-08-05 |