Individual
MICHAEL EDWARD BOEHM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
1280 E POLSTON AVE, POST FALLS, ID 83854-6056
(208) 773-5505
(208) 457-1712
Mailing address
1280 E POLSTON AVE, POST FALLS, ID 83854-6056
(208) 773-5505
(208) 457-1712
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D3669
ID
Other
Enumeration date
10/13/2010
Last updated
10/13/2010
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