Individual
TODD SQUIRES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
2811 12TH AVE RD, NAMPA, ID 83686-8482
(208) 466-2458
Mailing address
15410 BARRETT VIEW CIR, CALDWELL, ID 83607-9668
(801) 682-3097
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D-4658
ID
Other
Enumeration date
06/24/2015
Last updated
05/18/2020
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