Boise Smiles Youth Dentistry, Pllc

LBN: Boise Smiles Youth Dentistry, Pllc
Boise Smiles Youth Dentistry, Pllc is an health care organization with primary practice located at 8744 Fairview Ave , Boise ID 83704-8207. The organization recently has only one registered license in Dental Providers / General Practice, which is considered as the primary health care specialty. Boise Smiles Youth Dentistry, Pllc can be contacted via phone (208) 322-3010, or through Stump, Jenell via phone (615) 750-0343.

Contact Information

Primary practice address
8744 Fairview Ave Boise ID 83704-8207
Phone: (208) 322-3010
Fax: (208) 322-9273
Website:
Map and Directions
Authorized official contact:
Name: Stump, Jenell
Phone: (615) 750-0343

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / General Practice 1223G0001X

Profile Details

NPI number 1033154604
LBN Legal business name Boise Smiles Youth Dentistry, Pllc
DBA Doing business as
Authorized official Stump, Jenell
Entity Organization
Organization subpart 1 No
Enumeration date Jun 18th, 2006
Last updated Jul 9th, 2014 - about 11 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 1033154604 NPPES
Idaho MEDICAID 807095000

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