Organization
EMERALD SMILES DENTISTRY, PC
Active
Other names
Emerald Smiles Dentistry
Organization subpart
No
Provider details
NPI number
Authorized official
KENNETH C BENSON DMD (OWNER)
(208) 593-3221
Entity
Organization
Contact information
Practice address
675 N MILWAUKEE ST STE 110, BOISE, ID 83704-9185
(208) 593-3221
Mailing address
PO BOX 920050, DALLAS, TX 75392-0050
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
Other
Enumeration date
08/15/2022
Last updated
08/15/2022
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