Organization
BOISE BENCH DENTISTRY
Active
Other names
Emerald Dental Associates PC
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JILL SHELTON WAGERS DMD (DENTIST)
(208) 327-0337
Entity
Organization
Contact information
Practice address
7235 W EMERALD STREET, SUITE B, BOISE, ID 83704-8600
(208) 327-0337
(208) 376-0468
Mailing address
7235 W EMERALD STREET, SUITE B, BOISE, ID 83704-8600
(208) 327-0337
(208) 376-0468
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
Other
Enumeration date
10/01/2007
Last updated
06/02/2021
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