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Organization
LINEBERRY ORTHODONTICS
Active
Organization
LINEBERRY ORTHODONTICS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LAURA LINEBERRY (ORTHODONTIST)
(208) 658-9470
Entity
Organization
Contact information
Practice address
13059 W PERSIMMON LN, BOISE, ID 83713-1986
(208) 658-9470
(208) 658-0778
Mailing address
13059 W PERSIMMON LN, BOISE, ID 83713-1986
(208) 658-9470
(208) 658-0778
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
D3184OR
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8053305
—
ID
Enumeration date
03/11/2009
Last updated
03/11/2009
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