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Individual

CAROLINE PRUITT IRONS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
1529 S TIMESQUARE LN, BOISE, ID 83709-8201
(208) 343-1981
Mailing address
534 BRANBURY CT, BRANDON, MS 39047-8019
(601) 325-6319

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D-5440
ID

Other

Enumeration date
08/10/2022
Last updated
08/10/2022
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