Individual
DR. BROCK WINSTON HYDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
13108 W PERSIMMON LN, BOISE, ID 83713-1986
(208) 377-2160
(208) 376-6440
Mailing address
13108 W PERSIMMON LN, BOISE, ID 83713-1986
(208) 377-2160
(208) 376-6440
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
D-4954
ID
Other
Enumeration date
07/16/2018
Last updated
07/16/2018
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