Boise Towne Square Dental

NPI #1104026822 in Boise, Idaho

Provider Information

NPI Number: 1104026822
Entity Type: Organization
Organization Name: Boise Towne Square Dental
Primary Specialty: Dentist - General Practice
Enumeration Date: Jul 20, 2007
Last Updated: Jul 20, 2007

Practice Location

Address: 7677 W EMERALD ST
City: Boise
State: Idaho
ZIP Code: 83704-9018
Phone: (208) 888-0662

Authorized Official

Name: DR. WADE PILLING, D.M.D
Title: OWNER
Phone: (208) 888-0662

Specialties & Taxonomy Codes

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

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