Platinum Dental Pllc

NPI #1760762868 in Boise, Idaho

Provider Information

NPI Number: 1760762868
Entity Type: Organization
Organization Name: Platinum Dental Pllc
Primary Specialty: Dentist - General Practice
Enumeration Date: Aug 19, 2011
Last Updated: Mar 7, 2018

Practice Location

Address: 9502 W FAIRVIEW AVE
City: Boise
State: Idaho
ZIP Code: 83704-8103
Phone: (208) 377-2223

Authorized Official

Name: DR. RICHARD RYAN DAVIS, DDS
Title: OWNER/ DENTIST
Phone: (208) 440-7384

Specialties & Taxonomy Codes

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

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