Demetter, Randy

Demetter, Randy is an sole proprietor health care provider with primary practice located at 140 E Boise Ave , Boise ID 83706-4302. He recently has only one registered license in Dental Providers / Periodontics, which is considered as his primary health care specialty. Demetter, Randy can be contacted via phone (208) 385-9228.

Contact Information

Primary practice address
140 E Boise Ave Boise ID 83706-4302
Phone: (208) 385-9228
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Periodontics 1223P0300X ETN283 Texas
Dental Providers / Periodontics 1223P0300X D-4831-PE Idaho

Profile Details

NPI number 1275941288
LBN Legal business name Demetter, Randy
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jul 23rd, 2014
Last updated Apr 5th, 2023 - about last year

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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