North End Dental Pllc

NPI #1902916018 in Boise, Idaho

Provider Information

NPI Number: 1902916018
Entity Type: Organization
Organization Name: North End Dental Pllc
Primary Specialty: Dentist - General Practice
Enumeration Date: Aug 30, 2006
Last Updated: Dec 11, 2009

Practice Location

Address: 704 N 17TH STREET
City: Boise
State: Idaho
ZIP Code: 83702
Phone: (208) 344-0134

Authorized Official

Name: MRS. DOROTHY ANN MATTEFS
Title: OFF MGR
Phone: (208) 344-0134

Specialties & Taxonomy Codes

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

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