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Individual

BOSTON WEBB

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DMD

Contact information

Practice address
1515 N 400 E STE 104, NORTH LOGAN, UT 84341-7595
(208) 232-7862
Mailing address
500 S 11TH AVE STE 400, POCATELLO, ID 83201-4880
(208) 232-7862

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
14224390-9923
UT

Other

Enumeration date
05/22/2025
Last updated
05/22/2025
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