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1487230009
IDAHO DENTAL PROFESSIONALS, P.C.
BOISE, ID
NPI
1487230009
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Entity Type
Organization
Authorized Contact
TABATHA LEMKE
Credentialing COO Rdinator
217-540-6078
Organization Subpart ?
Yes
Primary Taxonomy
1223G0001X Dentist General Practice
Enumeration Date
2021-03-23
Last Update Date
2021-03-23
Business Address
IDAHO DENTAL PROFESSIONALS, P.C.
6085 N EAGLE RD
BOISE, ID 83713-0997
Phone number: 208-938-9912
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Mailing Address
IDAHO DENTAL PROFESSIONALS, P.C.
6085 N EAGLE RD
BOISE, ID 83713-0997
Phone number: 208-938-9912
Copy
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