Individual
MRS. HEIDI MARIE VAN GIFFEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
L.D.
Contact information
Practice address
6051 N EAGLE RD, BOISE, ID 83713-0997
(208) 336-8873
Mailing address
6051 N EAGLE RD, BOISE, ID 83713-0997
(208) 336-8873
Taxonomy
Speciality
Code
Description
License number
State
122400000X
Denturist
DT-DO-10112253
OR
122400000X
Denturist
Primary
LD-106
ID
Other
Enumeration date
05/07/2007
Last updated
04/21/2025
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