| Boise Integrative Dentistry | |
|
7878 W Ustick Rd Suite 101 Boise ID 83704-5006 | |
| (208) 376-2920 | |
| (208) 376-8509 |
| Full Name | Boise Integrative Dentistry |
|---|---|
| Speciality | Dentist |
| Location | 7878 W Ustick Rd, Boise, Idaho |
| Authorized Official Name and Position | June Alice Juhnke (OFFICE MANAGER) |
| Authorized Official Contact | 2083360003 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Boise Integrative Dentistry 7878 W Ustick Rd Suite 101 Boise ID 83704-5006 Ph: (208) 376-2920 | Boise Integrative Dentistry 7878 W Ustick Rd Suite 101 Boise ID 83704-5006 Ph: (208) 376-2920 |
| NPI Number | 1336340785 |
|---|---|
| Provider Enumeration Date | 05/31/2007 |
| Last Update Date | 09/21/2022 |
| Medicare PECOS PAC ID | 8224209051 |
|---|---|
| Medicare Enrollment ID | O20110927000440 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1336340785 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | D1626 (Idaho) | Primary |
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