Charles Rollin Westerberg, LD LICENSED DENTURIS

NPI #1659760684 in Boise, Idaho

Provider Information

NPI Number: 1659760684
Entity Type: Individual
Name: Charles Rollin Westerberg, LD LICENSED DENTURIS
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Denturist
Credential: LD LICENSED DENTURIS
Enumeration Date: Jan 14, 2015
Last Updated: Jan 14, 2015

Practice Location

Address: 6710 W. OVERLAND RD.
City: Boise
State: Idaho
ZIP Code: 83709
Phone: (208) 323-7790

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Denturist	122400000X	Primary

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