Blair Pediatric Dentistry Pc | |
5360 N Eagle Rd Suite 103 Boise ID 83713-4901 | |
(208) 938-9958 | |
Not Available |
Full Name | Blair Pediatric Dentistry Pc |
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Speciality | Dentist - Pediatric Dentistry |
Location | 5360 N Eagle Rd, Boise, Idaho |
Authorized Official Name and Position | Randall P Blair (PRESIDENT) |
Authorized Official Contact | 7024859804 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Blair Pediatric Dentistry Pc 5360 N Eagle Rd Suite 103 Boise ID 83713-4901 Ph: (208) 938-9958 | Blair Pediatric Dentistry Pc 5360 N Eagle Rd Suite 103 Boise ID 83713-4901 Ph: (208) 938-9958 |
NPI Number | 1629483987 |
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Provider Enumeration Date | 06/25/2014 |
Last Update Date | 06/25/2014 |
Identifier | Type | State | Issuer |
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1629483987 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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1223P0221X | Dentist - Pediatric Dentistry | D4550PD (Idaho) | Primary |
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