Individual
DANIEL REED BODILY II
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MDM
Contact information
Practice address
1003 N 8TH ST, BOISE, ID 83702-4218
(208) 342-6549
(208) 336-6760
Mailing address
1003 N 8TH ST, BOISE, ID 83702-4218
(208) 342-6549
(208) 336-6760
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
D3109
ID
Other
Enumeration date
11/10/2006
Last updated
07/08/2007
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