# ALL PHASES DENTISTRY PLLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Craig C Sjoberg Sole Member
- **Organization subpart:** No

## Provider details

- **NPI number:** 1992117287
- **Authorized official:** MRS. ANISSA FERGUSON (BUSINESS MANAGER)
- **Authorized official phone:** (208) 695-5913

## Contact information

- **Practice address:** 3810 N GARDEN CENTER WAY, BOISE, ID 83703-5007
- **Practice address phone:** (208) 853-5111
- **Practice address fax:** (208) 853-5112
- **Mailing address:** 3810 N GARDEN CENTER WAY, BOISE, ID 83703-5007
- **Mailing address phone:** (208) 853-5111
- **Mailing address fax:** (208) 853-5112

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | D4200 | ID | Yes |

## Other

- **Enumeration date:** 05/21/2014
- **Last updated:** 05/21/2014