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. Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES. Last updated on 13 May, 2024.