Individual
DR. LAURA KATHLEEN LINEBERRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.D.S., M.S.
Contact information
Practice address
13059 W PERSIMMON LN, BOISE, ID 83713-1986
(208) 658-9470
(208) 658-0778
Mailing address
13059 W PERSIMMON LN, BOISE, ID 83713-1986
(208) 658-9470
(208) 658-0778
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
D3184OR
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
805330500
—
ID
Enumeration date
04/28/2008
Last updated
04/28/2008
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