| Brookdale Dental, Pa | |
|
13219 W Persimmon Ln Boise ID 83713-1986 | |
| (208) 373-0018 | |
| (208) 378-9676 |
| Full Name | Brookdale Dental, Pa |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 13219 W Persimmon Ln, Boise, Idaho |
| Authorized Official Name and Position | Robert Eric Barney (OWNER) |
| Authorized Official Contact | 2083730018 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Brookdale Dental, Pa 13219 W Persimmon Ln Boise ID 83713-1986 Ph: (208) 373-0018 | Brookdale Dental, Pa 13219 W Persimmon Ln Boise ID 83713-1986 Ph: (208) 373-0018 |
| NPI Number | 1497926521 |
|---|---|
| Provider Enumeration Date | 03/17/2008 |
| Last Update Date | 03/17/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1497926521 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
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