Individual
DR. ANDREW BETH CHRISMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
704 N 17TH STREET, BOISE, ID 83702-3905
(208) 344-0134
(208) 388-3990
Mailing address
704 N 17TH STREET, BOISE, ID 83702-3905
(208) 344-0134
(208) 388-3990
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D 1935
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
6P102
BLUE CROSS
ID
Enumeration date
12/19/2006
Last updated
07/08/2007
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