Individual
KOALBY BROWN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
13219 W PERSIMMON LN, BOISE, ID 83713-1986
(208) 373-0018
(208) 378-9676
Mailing address
13219 W PERSIMMON LN, BOISE, ID 83713-1986
(208) 373-0018
(208) 378-9676
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D4924
ID
Other
Enumeration date
06/01/2018
Last updated
04/30/2026
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