Individual
CHARLES ROLLIN WESTERBERG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LD LICENSED DENTURIS
Contact information
Practice address
6710 W. OVERLAND RD., BOISE, ID 83709
(208) 323-7790
Mailing address
6710 W OVERLAND RD., BOISE, ID 83709
(208) 323-7790
Taxonomy
Speciality
Code
Description
License number
State
122400000X
Denturist
Primary
LD-46
ID
Other
Enumeration date
01/14/2015
Last updated
01/14/2015
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