Individual provider · NPI-1
Heidi Marie Van Giffen, L.D.
Denturist · Boise, ID
NPI number1700099694
StatusActive
Last updated in NPPESApr 21, 2025
Details
- NPI
- 1700099694
- Entity type
- Individual (NPI-1)
- Name
- Mrs. Heidi Marie Van Giffen
- Credential
- L.D.
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- May 7, 2007
- Certification date
- Apr 21, 2025
- Last updated
- Apr 21, 2025
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 122400000X | Denturist | LD-106 | ID | Yes |
| 122400000X | Denturist | DT-DO-10112253 | OR |
Practice location
6051 N Eagle RdBoise, ID 83713-0997
Phone 208-336-8873
Mailing address
6051 N Eagle RdBoise, ID 83713-0997
Phone 208-336-8873
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