NPI | 1609624139 |
---|---|
Doing Business As | GREENTREE DENTAL BOISE |
Entity Type | Organization |
Authorized Contact | JASON CHAMPAGNE Owner 775-359-3934 |
Organization Subpart ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice |
Enumeration Date | 2024-05-09 |
Last Update Date | 2024-05-09 |