Organization
PERIODONTAL HEALTH SPECIALISTS OF IDAHO
Active
Other names
Florence and Lincks and Associates
Organization subpart
No
Provider details
NPI number
Authorized official
RANDY S DEMETTER DDS, MS (OWNER/PARTNER)
(208) 385-9228
Entity
Organization
Contact information
Practice address
140 E BOISE AVE, BOISE, ID 83706
(208) 385-9228
(208) 385-9292
Mailing address
140 E BOISE AVE, BOISE, ID 83706
(208) 385-9228
(208) 385-9292
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
—
—
Other
Enumeration date
09/30/2014
Last updated
05/08/2023
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