Jon Koeltl DDS, PC
Jon Koeltl DDS, PC is a Dental Clinic/Center in Boise, Idaho. Registered with an NPI since 2025.
- In the registry since
- 2025
What do these letters mean?
- PC — Professional corporation
- A form of business registration, not a clinical qualification.
Practice location Address checks out
12349 W McMillan RdBoise, ID 83713-5052
Phone: (208) 322-1112
Fax: (208) 322-3928
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Dental Clinic/Center (primary) | Taxonomy 261QD0000X |
|---|
Record details
| NPI number | 1447048376 |
|---|---|
| Entity type | Organization (Type 2) |
| Organization subpart | No |
| Authorized official | Jon Koeltl — Owner/Dentist · (208) 322-1112 |
| Other names | Centennial Dental |
| NPI enumerated | April 29, 2025 |
| Last updated in NPPES | April 29, 2025 |
| Certification date | April 29, 2025 |
| Mailing address | 12349 W McMillan Rd, Boise, ID 83713-5052 |
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