Timothy C. Paventy Dmd, LLC

NPI #1649696741 in Boise, Idaho

Provider Information

NPI Number: 1649696741
Entity Type: Organization
Organization Name: Timothy C. Paventy Dmd, LLC
Primary Specialty: Dentist - General Practice
Enumeration Date: Mar 13, 2014
Last Updated: Mar 13, 2014

Practice Location

Address: 144 E MALLARD DR
City: Boise
State: Idaho
ZIP Code: 83706-3975
Phone: (208) 342-0873

Authorized Official

Name: TIMOTHY C PAVENTY, DMD
Title: OWNER/DENTIST
Phone: (208) 342-0315

Specialties & Taxonomy Codes

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

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