Organization
TOWNSQUARE DENTAL OF BLACKFOOT PLLC
Active
Other names
Townsquare Dental of Blackfoot
Organization subpart
No
Provider details
NPI number
Authorized official
BOONE ALLEN DDS (OWNER)
(208) 785-0878
Entity
Organization
Contact information
Practice address
1120 PARKWAY DR, BLACKFOOT, ID 83221-1651
(208) 785-0878
Mailing address
1120 PARKWAY DR, BLACKFOOT, ID 83221-1651
(208) 785-0878
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
12/18/2023
Last updated
12/18/2023
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