Organization
JAKE DABELL DENTAL BOISE PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STEPHANIE FRANK (INSURANCE COORDINATOR)
(509) 570-6879
Entity
Organization
Contact information
Practice address
9502 W FAIRVIEW AVE, BOISE, ID 83704-8103
(208) 377-2223
Mailing address
9502 W FAIRVIEW AVE, BOISE, ID 83704-8103
(208) 377-2223
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
261QD0000X
TAXONOMY
ID
Enumeration date
09/29/2022
Last updated
12/19/2022
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