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NPI 1467218552

OrganizationActive

Id Oms Specialty Dental Services, PLLC

NPI 1467218552 · Oral and Maxillofacial Surgery (Dentist) · Boise, ID

Provider details

NPI number: 1467218552
Entity type: Organization
Primary specialty: Oral and Maxillofacial Surgery (Dentist)Dental Providers
Parent organization: Id Oms Specialty Dental Services, PLLC
Authorized official: Charlotte Dasch, Director of Credentialing and Pr

Practice location

7910 W Ustick Rd

Boise, ID 83704-5850

Phone: (208) 322-5522

More ID providers

Mailing address

1610 54th Ave N Ste 205

Nashville, TN 37209-1442

Registry dates

Enumerated: 2024-02-26
Last updated: 2024-02-26

Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.

Id Oms Specialty Dental Services, PLLC — NPI 1467218552, Boise, ID | NPI Central