Individual
DR. JOHN C. SLATTERY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS, MS
Contact information
Practice address
600 E RIVERPARK LN, SUITE 100, BOISE, ID 83706-6551
(208) 433-1122
(208) 433-1125
Mailing address
600 E RIVERPARK LN, SUITE 100, BOISE, ID 83706-6551
(208) 433-1122
(208) 433-1125
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
D-3500-OR
ID
Other
Enumeration date
09/12/2006
Last updated
07/09/2007
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