| Hidden Creek Dental, Pllc | |
|
580 W Parkcenter Blvd Boise ID 83706-3659 | |
| (208) 336-8478 | |
| Not Available |
| Full Name | Hidden Creek Dental, Pllc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 580 W Parkcenter Blvd, Boise, Idaho |
| Authorized Official Name and Position | Ryan James Clark (SOLE OWNER/DENTIST) |
| Authorized Official Contact | 2083368478 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Hidden Creek Dental, Pllc 580 W Parkcenter Blvd Boise ID 83706-3659 Ph: (208) 336-8478 | Hidden Creek Dental, Pllc 580 W Parkcenter Blvd Boise ID 83706-3659 Ph: (208) 336-8478 |
| NPI Number | 1396554762 |
|---|---|
| Provider Enumeration Date | 12/31/2024 |
| Last Update Date | 12/31/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1396554762 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
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