Individual
DILLON SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
2619 W FAIRVIEW AVE STE 2100, BOISE, ID 83702-6722
(208) 706-2663
(208) 489-4300
Mailing address
190 E BANNOCK ST, BOISE, ID 83712-6241
(208) 381-8752
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA-1187
ID
363AM0700X
Medical Physician Assistant
PA173732
OR
Other
Enumeration date
10/07/2014
Last updated
09/09/2024
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