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Organization
PERIODONTAL HEALTH SPECIALISTS OF IDAHO
Active
Organization
PERIODONTAL HEALTH SPECIALISTS OF IDAHO
Active
Other names
Florence and Lincks and Associates
Organization subpart
No
Provider details
NPI number
Authorized official
RANDY S DEMETTER DDS, MS (OWNER/PARTNER)
(208) 385-9228
Entity
Organization
Contact information
Practice address
140 E BOISE AVE, BOISE, ID 83706
(208) 385-9228
(208) 385-9292
Mailing address
140 E BOISE AVE, BOISE, ID 83706
(208) 385-9228
(208) 385-9292
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
—
—
Other
Enumeration date
09/30/2014
Last updated
05/08/2023
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