# IDAHO DENTAL PROFESSIONALS, P.C.

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** IDAHO DENTAL PROFESSIONALS, P.C.
- **Other names:** Dayley Dental
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1760162812
- **Legal business name:** IDAHO DENTAL PROFESSIONALS, P.C.
- **Authorized official:** CEMYIRA MCDOUGAL (CREDENTIALING COORDINATOR)
- **Authorized official phone:** (217) 764-8609

## Contact information

- **Practice address:** 1578 S TIMESQUARE LN, BOISE, ID 83709-8266
- **Practice address phone:** (208) 321-1141
- **Mailing address:** 1578 S TIMESQUARE LN, BOISE, ID 83709-8266

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | — | — | Yes |

## Other

- **Enumeration date:** 07/24/2023
- **Last updated:** 07/24/2023