| NPI | 1689258758 |
|---|---|
| Doing Business As | BOISE PREMIER DENTISTRY |
| Entity Type | Organization |
| Authorized Contact | MARYAM MOGHADDASIAN Owner 208-794-6391 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist |
| Enumeration Date | 2021-05-05 |
| Last Update Date | 2021-05-05 |