Organization
IDAHO DENTAL PROFESSIONALS, P.C.
Active
Parent organization
IDAHO DENTAL PROFESSIONALS, P.C.
Other names
Dayley Dental
Organization subpart
Yes
Provider details
NPI number
Legal business name
IDAHO DENTAL PROFESSIONALS, P.C.
Authorized official
CEMYIRA MCDOUGAL (CREDENTIALING COORDINATOR)
(217) 764-8609
Entity
Organization
Contact information
Practice address
1578 S TIMESQUARE LN, BOISE, ID 83709-8266
(208) 321-1141
Mailing address
1578 S TIMESQUARE LN, BOISE, ID 83709-8266
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
07/24/2023
Last updated
07/24/2023
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