Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Lake Harbor Dental

Organization General Practice Dentistry · NPI 1639310089

Lake Harbor Dental is a General Practice Dentistry in Boise, Idaho. Licensed in Idaho. Registered with an NPI since 2009.

Licensed in
ID
In the registry since
2009
Specialties on file
2

Practice location Address checks out

5355 W State St
Boise, ID 83703-3333
Phone: (208) 853-4687
Fax: (208) 853-4690
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

General Practice Dentistry (primary) Taxonomy 1223G0001X · Licence D3044 (ID)
General Practice Dentistry Taxonomy 1223G0001X · Licence D4142 (ID)

Record details

NPI number1639310089
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Michael Peterson — President · (208) 853-4687
NPI enumeratedMarch 16, 2009
Last updated in NPPESMarch 16, 2009
Mailing address5355 W State St, Boise, ID 83703-3333

Other providers in Boise