Organization
DAMON A ANDERSON, DDS, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. TERESA D JARDINE (OFFICE ADMINISTRATOR)
(208) 376-2721
Entity
Organization
Contact information
Practice address
2455 N MILWAUKEE ST, BOISE, ID 83704-5736
(208) 376-2721
(208) 376-2756
Mailing address
2455 N MILWAUKEE ST, BOISE, ID 83704-5736
(208) 376-2721
(208) 376-2756
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
3787
ID
Other
Enumeration date
08/05/2007
Last updated
08/05/2007
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