Organization
AESTHETIC DENTAL ARTS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JERZY WOZNIAK DDS (PRESIDENT)
(208) 891-6596
Entity
Organization
Contact information
Practice address
8590 W FAIRVIEW AVE, BOISE, ID 83704-8320
(208) 891-6596
Mailing address
8590 W FAIRVIEW AVE, BOISE, ID 83704-8320
(208) 891-6596
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
D-4278
ID
Other
Enumeration date
09/12/2012
Last updated
09/12/2012
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