Organization
TIMES SQUARE DENTAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. GINA NETTLES (OFFICE MANAGER)
(208) 989-3727
Entity
Organization
Contact information
Practice address
1529 S TIMESQUARE LN, BOISE, ID 83709-8266
(208) 343-1981
Mailing address
1529 S TIMESQUARE LN, BOISE, ID 83709-8266
(208) 343-1981
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
08/06/2026
Last updated
08/06/2026
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