Organization
LAKE HARBOR DENTAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MICHAEL EUGENE PETERSON DDS, PA (PRESIDENT)
(208) 853-4687
Entity
Organization
Contact information
Practice address
5355 W STATE ST, BOISE, ID 83703-3333
(208) 853-4687
(208) 853-4690
Mailing address
5355 W STATE ST, BOISE, ID 83703-3333
(208) 853-4687
(208) 853-4690
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D3044
ID
1223G0001X
General Practice Dentistry
D4142
ID
Other
Enumeration date
03/16/2009
Last updated
03/16/2009
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us