Hisel INC

NPI #1508038316 in Boise, Idaho

Provider Information

NPI Number: 1508038316
Entity Type: Organization
Organization Name: Hisel INC
Primary Specialty: Dentist - General Practice
Enumeration Date: Apr 1, 2008
Last Updated: Jun 24, 2008

Practice Location

Address: 10162 W FAIRVIEW AVE
City: Boise
State: Idaho
ZIP Code: 83704-8117
Phone: (208) 375-0192

Authorized Official

Name: DR. JOHN E HISEL II, DDS
Title: OWNER/DENTIST
Phone: (208) 375-0192

Specialties & Taxonomy Codes

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

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