PERIODONTAL HEALTH SPECIALISTS OF IDAHO NPI 1689077026

NPI Information

PERIODONTAL HEALTH SPECIALISTS OF IDAHO is a periodontics dentist in Boise, ID. The provider is that specialty of dentistry which encompasses the prevention, diagnosis and treatment of diseases of the supporting and surrounding tissues of the teeth or their substitutes and the maintenance of the health, function and esthetics of these structures and tissues. PERIODONTAL HEALTH SPECIALISTS OF IDAHO NPI is 1689077026. The provider is registered as an organization entity type and is a single specialty group.
The provider Former Legal Business Name Is Florence And Lincks And Associates.

The provider's business location address is:

140 E BOISE AVE
BOISE, ID
ZIP 83706
Phone: (208) 385-9228
Fax: (208) 385-9292

The provider's authorized official is Randy S Demetter .
The authorized official title is Owner/partner and has the following contact phone number (208) 385-9228.

The enumeration date for this NPI number is 9/30/2014 and was last updated on 5/8/2023.

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:

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