Organization
BURLEY FAMILY DENTAL PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ELAINE ANNETTE HANSEN (OFFICE MANAGER)
(208) 878-6684
Entity
Organization
Contact information
Practice address
2200 PARKE AVE STE 2, BURLEY, ID 83318
(208) 878-6684
Mailing address
2200 PARKE AVE STE 2, BURLEY, ID 83318
(208) 878-6684
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
11/27/2018
Last updated
11/27/2018
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