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NPI 1689258758

OrganizationActive

Boise Premier Dentistry

NPI 1689258758 · Dentist · Boise, ID

Provider details

NPI number: 1689258758
Entity type: Organization
Primary specialty: DentistDental Providers
Authorized official: Maryam Moghaddasian, Owner

Practice location

3809 W State St

Boise, ID 83703-5221

Phone: (208) 551-5155

More ID providers

Mailing address

3809 W State St

Boise, ID 83703-5221

Registry dates

Enumerated: 2021-05-05
Last updated: 2021-05-05

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

Boise Premier Dentistry — NPI 1689258758, Boise, ID | NPI Central