Idaho State University
Idaho State University provides Dentist services in Boise, Idaho. Licensed in Idaho. Registered with an NPI since 2007.
- Licensed in
- ID
- In the registry since
- 2007
Practice location Address checks out
2033 E Summersweet DrBoise, ID 83716-6695 Not confirmed with CMS for 18 years — call before visiting
Phone: (208) 331-0182
Fax: (208) 331-0184
Show map & directions
Directions in Google Maps · Apple Maps · OpenStreetMap
Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Dentist (primary) | Taxonomy 122300000X · Licence D-1819 (ID) |
|---|
Record details
| NPI number | 1912110164 |
|---|---|
| Entity type | Organization (Type 2) |
| Organization subpart | No |
| Authorized official | Tina Freeman — Office Manager · (208) 331-0182 |
| NPI enumerated | May 7, 2007 |
| Last updated in NPPES | June 24, 2008 |
| Mailing address | 2033 E Summersweet Dr, Boise, ID 83716-6695 |
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