LAKE HARBOR DENTAL PLLC

BOISE, ID
NPI1427669720
Entity TypeOrganization
Authorized ContactERIC BALLOU
Owner
208-853-4687
Organization Subpart ?No
Primary Taxonomy261QD0000X Clinic/Center, Dental
Enumeration Date2020-08-11
Last Update Date2020-08-11
Business Address
LAKE HARBOR DENTAL PLLC
5355 W STATE ST
BOISE, ID 83703-3333
Phone number: 208-853-4687
Mailing Address
LAKE HARBOR DENTAL PLLC
5355 W STATE ST
BOISE, ID 83703-3333
Phone number: 208-853-4687
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