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Individual

R ERIC BARNEY

Active
Sole proprietor

Provider details

NPI number
Gender
Man
Credential
DDS

Contact information

Practice address
13219 W PERSIMMON LN, BOISE, ID 83713-1986
(208) 373-0018
Mailing address
13219 W PERSIMMON LN, BOISE, ID 83713-1986
(208) 373-0018

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
D3210
ID

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
D3210
STATE LICENSE #
ID
Enumeration date
05/12/2006
Last updated
07/08/2007
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