Individual
DR. JOHN EUGENE HISEL JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
10162 W FAIRVIEW AVE, BOISE, ID 83704-8117
(208) 375-0192
(208) 378-7333
Mailing address
10162 W FAIRVIEW AVE, BOISE, ID 83704-8117
(208) 375-0192
(208) 378-7333
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
D1963
ID
Other
Enumeration date
06/20/2006
Last updated
04/01/2008
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