| Dentistry One Of Idaho Pc | |
|
800 W Main St Ste 1460 Boise ID 83702-5983 | |
| (877) 712-7875 | |
| Not Available |
| Full Name | Dentistry One Of Idaho Pc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 800 W Main St Ste 1460, Boise, Idaho |
| Authorized Official Name and Position | Brant Herman (CEO) |
| Authorized Official Contact | 8777127875 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Dentistry One Of Idaho Pc 460 Main St Ste B Metuchen NJ 08840-1834 Ph: () - | Dentistry One Of Idaho Pc 800 W Main St Ste 1460 Boise ID 83702-5983 Ph: (877) 712-7875 |
| NPI Number | 1275314866 |
|---|---|
| Provider Enumeration Date | 10/10/2023 |
| Last Update Date | 10/10/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1275314866 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
| 1223P0221X | Dentist - Pediatric Dentistry | (* (Not Available)) | Secondary |
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