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Black Bear Dental PLLC — NPI 1710719216, Boise, ID | NPI Central

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NPI 1710719216

OrganizationActive

Black Bear Dental PLLC

NPI 1710719216 · Dentist · Boise, ID

Provider details

NPI number: 1710719216
Entity type: Organization
Primary specialty: DentistDental Providers
Organization subpart: No
Authorized official: Mary Krajicek, Dentist(208) 906-3860

Specialties & taxonomies

DentistPrimary122300000X
Dental Providers

Practice location

600 E Riverpark Ln Ste 140

Boise, ID 83706-6509

Phone: (208) 906-3860

Approximate (ZIP-level) locationGet directions

More ID providers

Mailing address

600 E Riverpark Ln Ste 140

Boise, ID 83706-6509

Other names (DBA / former)

Doing business as: Parkcenter Smiles

Registry dates

Enumerated: 2024-08-14
Last updated: 2024-08-14
Certified: 2024-08-14

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