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Organization

EAGLE ANESTHESIA & ORAL SURGERY PLLC

Active
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Organization

EAGLE ANESTHESIA & ORAL SURGERY PLLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
RYAN JUDD DMD (DENTIST ANESTHESIOLOGIST)
(503) 679-9797
Entity
Organization

Contact information

Practice address
5266 N EAGLE RD, BOISE, ID 83713-0945
(503) 679-9797
Mailing address
37 W ARCHERFIELD ST STE 100, MERIDIAN, ID 83646-7721
(503) 679-9797

Taxonomy

Speciality
Code
Description
License number
State
1223D0004X
Dental Anesthesiology
Primary

Other

Enumeration date
08/07/2024
Last updated
08/07/2024
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