Idaho State University is a Dental Clinic in Boise, Idaho. It is located at 2033 E Summersweet Dr, Boise, ID and its contact number is 208-331-0182. The authorized person for Idaho State University is Ms. Tina M Freeman
who is Office Manager of the clinic and their contact number is 208-331-0182. The primary license number for Idaho State University is D-1819 (Dentist) in Idaho.
Idaho State University Clinic have dental surgeons who are specialized in dentistry, diagnosis, prevention, and treatment of diseases and conditions of the oral cavity. The dentist's supporting team aids in providing oral health services. The dental team includes dental assistants, dental hygienists, dental technicians, and sometimes dental therapists.
Complete Clinic Profile:
Idaho State University Clinic speciality, address, contact phone number and fax are as below.
Patients can call on the below given phone number for appointments.
| Name: | Idaho State University |
| Specialization: | Dentistry |
| Clinic Address: | 2033 E Summersweet Dr, Boise,
Idaho, 83716-6695 |
| Phone: | 208-331-0182 |
| Fax: | 208-331-0184 |
Authorized/Official Person Profile:
Officially authorized person to contact for any management issues or complaints for this clinic are as below. Person's position and contact details are also mentioned below.
| Name: | Ms. Tina M Freeman |
| Position: | Office Manager |
| Contact Number: | 208-331-0182 |
Professional Identification Codes:
NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS).
NPI details for Idaho State University clinic are as mentioned below.
| NPI Number: | 1912110164 |
| NPI Enumeration Date: | 07 May, 2007 |
| NPI Last Update On: | 24 Jun, 2008 |
Medical Licenses:
Organizations can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Idaho State University are as mentioned below.
| Specialization | License Number | State | Status | |
| Dentist | D-1819 | Idaho | Primary | |
Other Medical Identifiers:
Other legacy medical identifiers of the clinic such as Medicaid, Medicare PIN, NSC, UPIN etc. are mentioned as below.
| Identifier | Type | State | Issuer |
| 807200600 | Medicaid | Idaho | |
Business Mailing Address:
Business mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned address.
| Address: | Idaho State University
2033 E Summersweet Dr,
Boise, Idaho |
| Zip: | 83716-6695 |
| Phone Number: | 208-331-0182 |
| Fax Number: | 208-331-0184 |
Patients can reach Idaho State University at
2033 E Summersweet Dr, Boise, Idaho or can
call to book an appointment on 208-331-0182.
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**Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES. Last updated on
08 December, 2025.