Riverview Dental South Pllc

NPI #1780413112 in Boise, Idaho

Provider Information

NPI Number: 1780413112
Entity Type: Organization
Organization Name: Riverview Dental South Pllc
Subpart: Yes (part of a larger organization)
Parent Organization: RIVERVIEW DENTAL PLLC
Primary Specialty: Dentist - General Practice
Enumeration Date: Aug 1, 2024
Last Updated: Aug 1, 2024

Practice Location

Address: 1331 S FIVE MILE RD
City: Boise
State: Idaho
ZIP Code: 83709
Phone: (208) 375-3754

Authorized Official

Name: MRS. ERIN COLLEEN SHEA
Title: OFFICE MANAGER
Phone: (208) 375-3754

Specialties & Taxonomy Codes

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

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