Organization
ART DENTAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. NATHANIEL ROYAL SKOUSEN DMD (PRESIDENT)
(208) 375-3755
Entity
Organization
Contact information
Practice address
1212 N COLE RD, BOISE, ID 83704-8646
(208) 375-3755
(208) 323-7677
Mailing address
1212 N COLE RD, BOISE, ID 83704-8646
(208) 375-3755
(208) 323-7677
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D4019
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
807579000
—
ID
01
—
9201730
IDAHO SMILES
ID
Enumeration date
01/22/2008
Last updated
01/22/2008
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