Boise Children's Dentistry Pllc | |
136 E Mallard Dr Boise ID 83706-3975 | |
(208) 500-5437 | |
(208) 908-6178 |
Full Name | Boise Children's Dentistry Pllc |
---|---|
Speciality | Dentist - Pediatric Dentistry |
Location | 136 E Mallard Dr, Boise, Idaho |
Authorized Official Name and Position | Alexis Phillips Lyall (OWNER DENTIST) |
Authorized Official Contact | 2085005437 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Boise Children's Dentistry Pllc 136 E Mallard Dr Boise ID 83706-3975 Ph: (208) 500-5437 | Boise Children's Dentistry Pllc 136 E Mallard Dr Boise ID 83706-3975 Ph: (208) 500-5437 |
NPI Number | 1700503133 |
---|---|
Provider Enumeration Date | 10/26/2022 |
Last Update Date | 10/26/2022 |
Identifier | Type | State | Issuer |
---|---|---|---|
1700503133 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1223P0221X | Dentist - Pediatric Dentistry | (* (Not Available)) | Primary |
261QD0000X | Clinic/center - Dental | (* (Not Available)) | Secondary |
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