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Individual

SCOTT FREEMAN

Active
Sole proprietor

Provider details

NPI number
Gender
Man
Credential
DMD, PA

Contact information

Practice address
6363 EMERALD, BOISE, ID 83904
(208) 377-2150
Mailing address
6363 EMERALD, BOISE, ID 83904
(208) 377-2150

Taxonomy

Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
D1479
ID

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
D1479
STATE LICENSE #
ID
Enumeration date
05/19/2006
Last updated
07/08/2007
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