Individual
ANDREW PHILLIPS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
3003 S TRAILWOOD WAY, BOISE, ID 83716-5800
(770) 856-1357
Mailing address
3003 S TRAILWOOD WAY, BOISE, ID 83716-5800
(770) 856-1357
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
11509755-9922
UT
Other
Enumeration date
03/25/2020
Last updated
10/24/2023
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