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Organization
ID OMS SPECIALTY DENTAL SERVICES, PLLC
Active
Organization
ID OMS SPECIALTY DENTAL SERVICES, PLLC
Active
Parent organization
ID OMS SPECIALTY DENTAL SERVICES, PLLC
Other names
Boise Oral Surgery & Implant Center
Organization subpart
Yes
Provider details
NPI number
Legal business name
ID OMS SPECIALTY DENTAL SERVICES, PLLC
Authorized official
CHARLOTTE DASCH (DIRECTOR OF CREDENTIALING AND PR)
(615) 678-0759
Entity
Organization
Contact information
Practice address
7910 W USTICK RD, BOISE, ID 83704-5850
(208) 322-5522
Mailing address
1610 54TH AVE N STE 205, NASHVILLE, TN 37209-1442
(615) 678-0759
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
—
NULL
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
—
—
Other
Enumeration date
02/26/2024
Last updated
02/26/2024
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