| Austin Creek Dental Pc | |
|
4840 N Rosepoint Way Ste A Boise ID 83713 | |
| (208) 938-1825 | |
| (208) 938-5763 |
| Full Name | Austin Creek Dental Pc |
|---|---|
| Speciality | Dentist |
| Location | 4840 N Rosepoint Way, Boise, Idaho |
| Authorized Official Name and Position | Timothy A Hansen (PRESIDENT) |
| Authorized Official Contact | 2089381825 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Austin Creek Dental Pc 4840 N Rosepoint Way Ste. A. Boise ID 83713 Ph: (208) 938-1825 | Austin Creek Dental Pc 4840 N Rosepoint Way Ste A Boise ID 83713 Ph: (208) 938-1825 |
| NPI Number | 1710299433 |
|---|---|
| Provider Enumeration Date | 07/10/2010 |
| Last Update Date | 07/10/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1710299433 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | D-3513 (Idaho) | Primary |
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