Individual
KENNETH G BARANCO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
314 W BANNOCK ST, BOISE, ID 83702-6032
(208) 336-9333
(208) 387-1951
Mailing address
314 W BANNOCK ST, BOISE, ID 83702-6032
(208) 336-9333
(208) 387-1951
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
D1548
ID
Other
Enumeration date
08/12/2006
Last updated
07/08/2007
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