| Idaho Dental Professionals, P.c. | |
|
1578 S Timesquare Ln Boise ID 83709-8266 | |
| (208) 321-1141 | |
| Not Available |
| Full Name | Idaho Dental Professionals, P.c. |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 1578 S Timesquare Ln, Boise, Idaho |
| Authorized Official Name and Position | Cemyira Mcdougal (CREDENTIALING COORDINATOR) |
| Authorized Official Contact | 2177648609 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Idaho Dental Professionals, P.c. 1578 S Timesquare Ln Boise ID 83709-8266 Ph: () - | Idaho Dental Professionals, P.c. 1578 S Timesquare Ln Boise ID 83709-8266 Ph: (208) 321-1141 |
| NPI Number | 1760162812 |
|---|---|
| Provider Enumeration Date | 07/24/2023 |
| Last Update Date | 07/24/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1760162812 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
News Archive
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› Verified 9 days ago
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