| NPI | 1831468651 |
|---|---|
| Doing Business As | BOISE FAMILY DENTAL CARE |
| Entity Type | Organization |
| Authorized Contact | KIMBERLY DAWN SMITH Manager 208-376-7413 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305S00000X Point of Service (Licence: ID D4161) |
| Enumeration Date | 2011-12-22 |
| Last Update Date | 2011-12-22 |