Individual
TRAVIS JON WEIMER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
8336 W NORTHVIEW ST, BOISE, ID 83704-7132
(208) 375-4544
Mailing address
8336 W NORTHVIEW ST, BOISE, ID 83704-7132
(208) 375-4544
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D-5092
ID
Other
Enumeration date
05/16/2017
Last updated
01/04/2020
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