# PLATINUM DENTAL PLLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1760762868
- **Authorized official:** DR. RICHARD RYAN DAVIS DDS (OWNER/ DENTIST)
- **Authorized official phone:** (208) 440-7384

## Contact information

- **Practice address:** 9502 W FAIRVIEW AVE, BOISE, ID 83704-8103
- **Practice address phone:** (208) 377-2223
- **Mailing address:** 9502 W FAIRVIEW AVE, BOISE, ID 83704-8103
- **Mailing address phone:** (208) 377-2223

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | D4373 | ID | Yes |

## Other

- **Enumeration date:** 08/19/2011
- **Last updated:** 03/07/2018