| Idaho Dental Wellness Center | |
|
9203 W Overland Rd Boise ID 83709-2502 | |
| (208) 375-1012 | |
| Not Available |
| Full Name | Idaho Dental Wellness Center |
|---|---|
| Speciality | Dentist |
| Location | 9203 W Overland Rd, Boise, Idaho |
| Authorized Official Name and Position | Guy Matthew Hanson (PRESIDENT) |
| Authorized Official Contact | 2083751012 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Idaho Dental Wellness Center 9203 W Overland Rd Boise ID 83709-2502 Ph: (208) 375-1012 | Idaho Dental Wellness Center 9203 W Overland Rd Boise ID 83709-2502 Ph: (208) 375-1012 |
| NPI Number | 1255590105 |
|---|---|
| Provider Enumeration Date | 06/05/2008 |
| Last Update Date | 06/05/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1255590105 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | D1850 (Idaho) | Primary |
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