Lake Harbor Dental
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 StBoise, ID 83703-3333
Phone: (208) 853-4687
Fax: (208) 853-4690
Show map & directions
Directions in Google Maps · Apple Maps · OpenStreetMap
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 number | 1639310089 |
|---|---|
| Entity type | Organization (Type 2) |
| Organization subpart | No |
| Authorized official | Michael Peterson — President · (208) 853-4687 |
| NPI enumerated | March 16, 2009 |
| Last updated in NPPES | March 16, 2009 |
| Mailing address | 5355 W State St, Boise, ID 83703-3333 |
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