Boise Orthodontics P.A.

LBN: Boise Orthodontics P.A.
Boise Orthodontics P.A. is an health care organization with primary practice located at 4725 N Cloverdale Rd Suite 101, Boise ID 83713-4911. The organization recently has only one registered license in Dental Providers / Orthodontics and Dentofacial Orthopedics, which is considered as the primary health care specialty. Boise Orthodontics P.A. can be contacted via phone (208) 323-4458, or through Smith, Glen Allen via phone (208) 323-4458.

Contact Information

Primary practice address
4725 N Cloverdale Rd Suite 101 Boise ID 83713-4911
Fax:
Website:
Authorized official contact:
Name: Smith, Glen Allen DDS MS

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Orthodontics and Dentofacial Orthopedics 1223X0400X D-3036-OR Idaho

Profile Details

NPI number 1770754186
LBN Legal business name Boise Orthodontics P.A.
DBA Doing business as
Authorized official Smith, Glen Allen DDS MS
Entity Organization
Organization subpart 1 No
Enumeration date Mar 13th, 2008
Last updated Mar 13th, 2008 - about 17 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1770754186 NPPES
Idaho Other 6L271 BLUE CROSS ID
Idaho Other 734506 BLUE CROSS ID

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