IDAHO STATE UNIVERSITY

BOISE, ID
NPI1912110164
Entity TypeOrganization
Authorized ContactTINA M FREEMAN
Office Manager
208-331-0182
Organization Subpart ?No
Primary Taxonomy122300000X Dentist
(Licence: ID  D-1819)
Enumeration Date2007-05-07
Last Update Date2008-06-24
Business Address
IDAHO STATE UNIVERSITY
2033 E SUMMERSWEET DR
BOISE, ID 83716-6695
Phone number: 208-331-0182
Mailing Address
IDAHO STATE UNIVERSITY
2033 E SUMMERSWEET DR
BOISE, ID 83716-6695
Phone number: 208-331-0182
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