Individual
COLEMAN MOWER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
600 E RIVERPARK LN, BOISE, ID 83706-6551
(204) 344-5024
Mailing address
600 E RIVERPARK LN, BOISE, ID 83706-6551
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D-5632
ID
Other
Enumeration date
06/06/2024
Last updated
06/06/2024
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