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Individual

DR. KIP T KATSEANES

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DMD MSD

Contact information

Practice address
6019 N EAGLE RD, BOISE, ID 83713
(208) 377-2777
(208) 377-3075
Mailing address
6019 N EAGLE RD, BOISE, ID 83713
(208) 377-2777
(208) 377-3075

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
D5185PE
ID

Other

Enumeration date
06/25/2015
Last updated
09/15/2020
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