WHITEWATER ORAL SURGERY GROUP PLLC NPI 1104248053

NPI Information

WHITEWATER ORAL SURGERY GROUP PLLC is an oral and maxillofacial surgery dentist in Boise, ID. The provider is an oral and maxillofacial surgery dentist specialized in the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region. WHITEWATER ORAL SURGERY GROUP PLLC NPI is 1104248053. The provider is registered as an organization entity type and is a multiple single specialty group.

The provider's business location address is:

3003 W MAIN ST STE 130
BOISE, ID
ZIP 83702-026
Phone: (208) 342-7610
Fax: (208) 344-1799

The provider's authorized official is Kevin Glenn Kempers .
The authorized official title is Owner and has the following contact phone number (208) 342-7610.

The enumeration date for this NPI number is 1/13/2014 and was last updated on 9/4/2020.

Taxonomy Codes

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