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Organization
TOWNSQUARE DENTAL OF BLACKFOOT PLLC
Active
Organization
TOWNSQUARE DENTAL OF BLACKFOOT PLLC
Active
Other names
Townsquare Dental of Blackfoot
Organization subpart
No
Provider details
NPI number
Authorized official
BOONE ALLEN DDS (OWNER)
(208) 785-0878
Entity
Organization
Contact information
Practice address
1120 PARKWAY DR, BLACKFOOT, ID 83221-1651
(208) 785-0878
Mailing address
1120 PARKWAY DR, BLACKFOOT, ID 83221-1651
(208) 785-0878
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
12/18/2023
Last updated
12/18/2023
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