Organization
EAST BOISE DENTAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TODD BROYLES DDS (OWNER)
(208) 368-0500
Entity
Organization
Contact information
Practice address
150 E BOISE AVE, BOISE, ID 83706-4379
(208) 368-0500
Mailing address
150 E BOISE AVE, BOISE, ID 83706-4379
(208) 368-0500
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
D4068
ID
Other
Enumeration date
06/16/2011
Last updated
06/16/2011
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