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Individual

CHAD BODILY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
425 N OVERLAND AVE, BURLEY, ID 83318-3434
(208) 430-9555
Mailing address
425 N OVERLAND AVE, BURLEY, ID 83318-3434

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
D-4600
ID

Other

Enumeration date
07/01/2014
Last updated
08/14/2025
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