Tyler J Smith,pa

NPI #1427380203 in Boise, Idaho

Provider Information

NPI Number: 1427380203
Entity Type: Organization
Organization Name: Tyler J Smith,pa
Primary Specialty: Dentist - General Practice
Enumeration Date: Feb 4, 2010
Last Updated: Feb 4, 2010

Practice Location

Address: 2200 WARM SPRINGS AVE
Address 2: STE 108
City: Boise
State: Idaho
ZIP Code: 83712-8429
Phone: (208) 343-2000

Authorized Official

Name: DR. TYLER JOSHUA SMITH, DMD
Title: DENTIST/OWNER
Phone: (208) 343-2000

Specialties & Taxonomy Codes

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

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