Organization
CRUMP ENTERPRISES
Active
Other names
Boise Family Dental Care
Organization subpart
No
Provider details
NPI number
Authorized official
KIMBERLY DAWN SMITH (MANAGER)
(208) 376-7413
Entity
Organization
Contact information
Practice address
11311 W CHINDEN BLVD, BOISE, ID 83714-1021
(208) 908-4430
Mailing address
11311 W CHINDEN BLVD, BOISE, ID 83714-1021
(208) 908-4430
Taxonomy
Speciality
Code
Description
License number
State
305S00000X
Point of Service
Primary
D4161
ID
Other
Enumeration date
12/22/2011
Last updated
12/22/2011
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