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Organization

PUBLIC DENTURE CENTER

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MS. REBECCA LYNN WESTERBERG LD (DENTURIST HALF OWNER)
(208) 323-7790
Entity
Organization

Contact information

Practice address
6710 W OVERLAND RD, BOISE, ID 83709-2032
(208) 323-7790
Mailing address
6710 W OVERLAND RD, BOISE, ID 83709-2032
(208) 323-7790

Taxonomy

Speciality
Code
Description
License number
State
122400000X
Denturist
Primary
LD32
ID

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
9227466
ID
Enumeration date
12/10/2010
Last updated
12/10/2010
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