Ideal Dental

NPI #1073891461 in Caldwell, Idaho

Provider Information

NPI Number: 1073891461
Entity Type: Organization
Organization Name: Ideal Dental
Primary Specialty: Dentist - General Practice
Enumeration Date: Aug 2, 2011
Last Updated: Aug 2, 2011

Practice Location

Address: 329 E LOGAN ST
City: Caldwell
State: Idaho
ZIP Code: 83605-4863
Phone: (208) 459-3388

Authorized Official

Name: DR. TRAVIS BOYER
Title: OWNER
Phone: (208) 459-3388

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist - General Practice — General Practice	1223G0001X	Primary

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