Southwest Dental Associates

NPI #1124346499 in Boise, Idaho

Provider Information

NPI Number: 1124346499
Entity Type: Organization
Organization Name: Southwest Dental Associates
Primary Specialty: Dentist - General Practice
Enumeration Date: May 12, 2010
Last Updated: May 12, 2010

Practice Location

Address: 1201 S FIVE MILE RD
City: Boise
State: Idaho
ZIP Code: 83709-1304
Phone: (208) 322-5655

Authorized Official

Name: DR. JEFFREY TULLER, DDS
Title: DENTIST
Phone: (208) 322-5655

Specialties & Taxonomy Codes

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

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