| Idaho Dental Professionals, P.c. | |
|
6085 N Eagle Rd Boise ID 83713-0997 | |
| (208) 938-9912 | |
| Not Available |
| Full Name | Idaho Dental Professionals, P.c. |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 6085 N Eagle Rd, Boise, Idaho |
| Authorized Official Name and Position | Tabatha Lemke (CREDENTIALING COORDINATOR) |
| Authorized Official Contact | 2175406078 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Idaho Dental Professionals, P.c. 6085 N Eagle Rd Boise ID 83713-0997 Ph: (208) 938-9912 | Idaho Dental Professionals, P.c. 6085 N Eagle Rd Boise ID 83713-0997 Ph: (208) 938-9912 |
| NPI Number | 1487230009 |
|---|---|
| Provider Enumeration Date | 03/23/2021 |
| Last Update Date | 03/23/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1487230009 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
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