Boise Towne Square Dental

NPI #1346689866 in Boise, Idaho

Provider Information

NPI Number: 1346689866
Entity Type: Organization
Organization Name: Boise Towne Square Dental
Primary Specialty: Dentist
Enumeration Date: Jun 18, 2013
Last Updated: Jun 18, 2013

Practice Location

Address: 7677 W. EMERALD
City: Boise
State: Idaho
ZIP Code: 83704
Phone: (208) 639-4390

Authorized Official

Name: MR. RYAN LEE OLSON, DDS
Title: DR./OWNER
Phone: (208) 639-4390

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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