PUBLIC DENTURE CENTER NPI 1053614248

NPI Information

NPI: 1053614248
Provider Name: PUBLIC DENTURE CENTER
Classification: Denturist - 122400000X
Entity Type: Organization
Address:
6710 W OVERLAND RD
BOISE, ID
ZIP 83709
Phone: (208) 323-7790
Get Directions

PUBLIC DENTURE CENTER is a denturist in Boise, ID. The provider is a denturist is a licensed professional that serves patients with removable dental prosthetic oral health needs. A licensed denturist is trained in removable dental prosthetics and the fabrication of such devices. PUBLIC DENTURE CENTER NPI is 1053614248. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

6710 W OVERLAND RD
BOISE, ID
ZIP 83709-032
Phone: (208) 323-7790

The provider's authorized official is Rebecca Lynn Westerberg .
The authorized official title is DENTURIST HALF OWNERHalf Owner and has the following contact phone number (208) 323-7790.

The enumeration date for this NPI number is 12/10/2010 and was last updated on 12/10/2010.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	122400000X	Denturist		LD32	IDAHO	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	9227466	MEDICAID	IDAHO

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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