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Organization

DOWNTOWN DENTAL PLLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. RYAN KOWALCZYK DDS (DENTIST)
(208) 342-5444
Entity
Organization

Contact information

Practice address
1625 W BANNOCK ST, BOISE, ID 83702-5155
(208) 342-5444
Mailing address
1625 W BANNOCK ST, BOISE, ID 83702-5155
(208) 342-5444

Taxonomy

Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
D-3689
ID

Other

Enumeration date
12/08/2017
Last updated
12/06/2023
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