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Individual

TANISHA KHURANA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
1175 E PARKCENTER BLVD, BOISE, ID 83706-6751
(208) 888-5544
Mailing address
1062 E RUBICON DR, BOISE, ID 83716-5279

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D-5510
ID

Other

Enumeration date
05/15/2023
Last updated
05/15/2023
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