Organization
IDAHO ENDODONTICS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AMANDA MAYLIN DO (FRONT OFFICE)
(208) 672-8860
Entity
Organization
Contact information
Practice address
1555 S TIMESQUARE LN, BOISE, ID 83709-8266
(208) 672-8860
Mailing address
1555 S TIMESQUARE LN, BOISE, ID 83709-8266
(208) 672-8860
Taxonomy
Speciality
Code
Description
License number
State
1223E0200X
Endodontics
Primary
—
—
Other
Enumeration date
05/12/2020
Last updated
05/12/2020
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