Individual
DR. LARUE ANTOINE BLUTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
5244 N EAGLE RD, BOISE, ID 83713-0945
(208) 890-4980
Mailing address
5244 N EAGLE RD, BOISE, ID 83713-0945
(208) 890-4980
Taxonomy
Speciality
Code
Description
License number
State
1223E0200X
Endodontics
46364
CA
1223E0200X
Endodontics
Primary
D4267
ID
Other
Enumeration date
04/18/2007
Last updated
11/09/2009
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