Individual
DR. SCOTT LYNN WIDDISON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
4061 OVERLAND RD, BOISE, ID 83705-2970
(208) 343-1442
(208) 333-0265
Mailing address
4061 OVERLAND RD, BOISE, ID 83705-2970
(208) 343-1442
(208) 333-0265
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D3153
ID
Other
Enumeration date
06/03/2009
Last updated
06/03/2009
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