| Black Bear Dental Pllc | |
|
600 E Riverpark Ln Ste 140 Boise ID 83706-6509 | |
| (208) 906-3860 | |
| Not Available |
| Full Name | Black Bear Dental Pllc |
|---|---|
| Speciality | Dentist |
| Location | 600 E Riverpark Ln Ste 140, Boise, Idaho |
| Authorized Official Name and Position | Mary Krajicek (DENTIST) |
| Authorized Official Contact | 2089063860 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Black Bear Dental Pllc 600 E Riverpark Ln Ste 140 Boise ID 83706-6509 Ph: (208) 906-3860 | Black Bear Dental Pllc 600 E Riverpark Ln Ste 140 Boise ID 83706-6509 Ph: (208) 906-3860 |
| NPI Number | 1710719216 |
|---|---|
| Provider Enumeration Date | 08/14/2024 |
| Last Update Date | 08/14/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1710719216 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | (* (Not Available)) | Primary |
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