Times Square Dental

NPI #1942469713 in Boise, Idaho

Provider Information

NPI Number: 1942469713
Entity Type: Organization
Organization Name: Times Square Dental
Primary Specialty: Dentist - General Practice
Enumeration Date: Jun 5, 2008
Last Updated: Jun 5, 2008

Practice Location

Address: 1529 S TIMES SQUARE CRT
City: Boise
State: Idaho
ZIP Code: 83709
Phone: (208) 343-1981

Authorized Official

Name: DR. JON R HASTINGS, DDS
Title: DENTIST
Phone: (208) 343-1981

Specialties & Taxonomy Codes

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

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