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Contact Information

MILLENNIUM FAMILY DENTAL - BOISE LLC
813 STILSON RD
SUITE B
BOISE, ID83703
 Phone: 208-342-4644
 Fax: 208-367-0283
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

General Practice

1223G0001X
Indicates primary specialty

NPI Profile & details for MILLENNIUM FAMILY DENTAL BOISE LLC · (Female)

NPI # 1104925064
Status Active
Credentials
Entity Individual
Enumeration date 09/21/2006
Last updated 12/30/2014 - About 11 years ago
Sole proprietor 1 Not specified
Identifiers
  • ID Medicaid 806766100
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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