| Lineberry Orthodontics | |
|
13059 W Persimmon Ln Boise ID 83713-1986 | |
| (208) 658-9470 | |
| (208) 658-0778 |
| Full Name | Lineberry Orthodontics |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 13059 W Persimmon Ln, Boise, Idaho |
| Authorized Official Name and Position | Laura Lineberry (ORTHODONTIST) |
| Authorized Official Contact | 2086589470 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Lineberry Orthodontics 13059 W Persimmon Ln Boise ID 83713-1986 Ph: (208) 658-9470 | Lineberry Orthodontics 13059 W Persimmon Ln Boise ID 83713-1986 Ph: (208) 658-9470 |
| NPI Number | 1154562783 |
|---|---|
| Provider Enumeration Date | 03/11/2009 |
| Last Update Date | 03/11/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1154562783 | NPI | - | NPPES |
| 8053305 | Medicaid | ID |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | D3184OR (Idaho) | Primary |
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