BOISE SMILES YOUTH DENTISTRY PLLC NPI 1033154604

NPI Information

BOISE SMILES YOUTH DENTISTRY, PLLC is a general practice dentist in Boise, ID. The provider is a general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. BOISE SMILES YOUTH DENTISTRY, PLLC NPI is 1033154604. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

8744 FAIRVIEW AVE
BOISE, ID
ZIP 83704-207
Phone: (208) 322-3010
Fax: (208) 322-9273

The provider's authorized official is Jenell Stump .
The authorized official title is Manager, Licensing & Credentialing and has the following contact phone number (615) 750-0343.

The enumeration date for this NPI number is 6/18/2006 and was last updated on 7/9/2014.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

Other Identifiers

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