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Organization
BOISE BENCH DENTISTRY
Active
Organization
BOISE BENCH DENTISTRY
Active
Other names
Emerald Dental Associates PC
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JILL SHELTON WAGERS DMD (DENTIST)
(208) 327-0337
Entity
Organization
Contact information
Practice address
7235 W EMERALD STREET, SUITE B, BOISE, ID 83704-8600
(208) 327-0337
(208) 376-0468
Mailing address
7235 W EMERALD STREET, SUITE B, BOISE, ID 83704-8600
(208) 327-0337
(208) 376-0468
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
Other
Enumeration date
10/01/2007
Last updated
06/02/2021
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