Organization · NPI-2

Public Denture Center

Denturist · Boise, ID

NPI number1053614248
StatusActive
Last updated in NPPESDec 10, 2010

Details

NPI
1053614248
Entity type
Organization (NPI-2)
Legal business name
Public Denture Center
Organization subpart
No
Enumeration date
Dec 10, 2010
Last updated
Dec 10, 2010

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
122400000X DenturistLD32IDYes

Practice location

6710 W Overland Rd
Boise, ID 83709-2032

Phone 208-323-7790

Mailing address

6710 W Overland Rd
Boise, ID 83709-2032

Phone 208-323-7790

Authorized official

Rebecca Lynn Westerberg
Denturist Half Owner
2083237790

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