Matthew G. Fethke, D.d.s.,pc

NPI #1841450889 in Boise, Idaho

Provider Information

NPI Number: 1841450889
Entity Type: Organization
Organization Name: Matthew G. Fethke, D.d.s.,pc
Primary Specialty: Dentist - General Practice
Enumeration Date: Jun 12, 2008
Last Updated: Jun 12, 2008

Practice Location

Address: 12212 W AMITY RD
City: Boise
State: Idaho
ZIP Code: 83709-5389
Phone: (208) 343-4732

Authorized Official

Name: JANET D HEFNER
Title: OFFICE MANAGER
Phone: (208) 343-4732

Specialties & Taxonomy Codes

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

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