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Organization
PLATINUM DENTAL PLLC
Active
Organization
PLATINUM DENTAL PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RICHARD RYAN DAVIS DDS (OWNER/ DENTIST)
(208) 440-7384
Entity
Organization
Contact information
Practice address
9502 W FAIRVIEW AVE, BOISE, ID 83704-8103
(208) 377-2223
Mailing address
9502 W FAIRVIEW AVE, BOISE, ID 83704-8103
(208) 377-2223
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D4373
ID
Other
Enumeration date
08/19/2011
Last updated
03/07/2018
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