| Facial Trauma Associates Pllc | |
|
1000 N Curtis Rd Ste 103 Boise ID 83706-1345 | |
| (208) 343-0909 | |
| Not Available |
| Full Name | Facial Trauma Associates Pllc |
|---|---|
| Speciality | Oral & Maxillofacial Surgery |
| Location | 1000 N Curtis Rd Ste 103, Boise, Idaho |
| Authorized Official Name and Position | Cole W Anderson (MEMBER) |
| Authorized Official Contact | 2083430909 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Facial Trauma Associates Pllc 1000 N Curtis Rd Ste 103 Boise ID 83706-1345 Ph: (208) 343-0909 | Facial Trauma Associates Pllc 1000 N Curtis Rd Ste 103 Boise ID 83706-1345 Ph: (208) 343-0909 |
| NPI Number | 1568095883 |
|---|---|
| Provider Enumeration Date | 02/14/2020 |
| Last Update Date | 02/14/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1568095883 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0106X | Dentist - Oral And Maxillofacial Pathology | (* (Not Available)) | Secondary |
| 204E00000X | Oral & Maxillofacial Surgery | (* (Not Available)) | Primary |
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