Organization
BOISE CHILDREN'S DENTISTRY PLLC
Active
Other names
Dr. Alexis Phillips Kids Dentist
Organization subpart
No
Provider details
NPI number
Authorized official
ALEXIS PHILLIPS LYALL DMD (OWNER DENTIST)
(208) 500-5437
Entity
Organization
Contact information
Practice address
136 E MALLARD DR, BOISE, ID 83706-3975
(208) 500-5437
(208) 908-6178
Mailing address
136 E MALLARD DR, BOISE, ID 83706-3975
(208) 500-5437
(208) 908-6178
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
—
—
261QD0000X
Dental Clinic/Center
—
—
Other
Enumeration date
10/26/2022
Last updated
10/26/2022
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