Organization
SOUTHWEST DENTAL ASSOCIATES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JEFFREY TULLER DDS (DENTIST)
(208) 322-5655
Entity
Organization
Contact information
Practice address
1201 S FIVE MILE RD, BOISE, ID 83709-1304
(208) 322-5655
(208) 323-8160
Mailing address
1201 S FIVE MILE RD, BOISE, ID 83709-1304
(208) 322-5655
(208) 323-8160
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D2065
ID
Other
Enumeration date
05/12/2010
Last updated
05/12/2010
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