| Sprout Pediatric Dentistry,pllc | |
|
7800 W Ustick Rd Boise ID 83704-5848 | |
| (208) 576-6791 | |
| Not Available |
| Full Name | Sprout Pediatric Dentistry,pllc |
|---|---|
| Speciality | Dentist - Pediatric Dentistry |
| Location | 7800 W Ustick Rd, Boise, Idaho |
| Authorized Official Name and Position | Rachel Mitchell (BUSINESS MANAGER) |
| Authorized Official Contact | 2084675100 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Sprout Pediatric Dentistry,pllc 7800 W Ustick Rd Boise ID 83704-5848 Ph: (208) 576-6791 | Sprout Pediatric Dentistry,pllc 7800 W Ustick Rd Boise ID 83704-5848 Ph: (208) 576-6791 |
| NPI Number | 1114685245 |
|---|---|
| Provider Enumeration Date | 12/06/2021 |
| Last Update Date | 12/06/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1114685245 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0221X | Dentist - Pediatric Dentistry | (* (Not Available)) | Primary |
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