Organization · Type 2 NPI

Id Oms Specialty Dental Services, PLLC

Oral and Maxillofacial Surgery (Dentist) · Boise, ID

NPI number 1467218552 Active

Practice location

7910 W Ustick Rd
Boise, ID 83704-5850

Call (208) 322-5522 Map

Mailing address

1610 54th Ave N Ste 205
Nashville, TN 37209-1442

Specialties and licenses

Taxonomy	Code	License
Oral and Maxillofacial Surgery (Dentist) Primary	1223S0112X	None listed

Oral and Maxillofacial Surgery (Dentist): The specialty of dentistry which includes the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region.

Another provider at this address

Brett BeckerOral and Maxillofacial Surgery (Dentist) Boise, ID NPI 1841933108

Other oral and maxillofacial surgery (dentist) providers in Boise

See all in Boise →

NPI record

NPI: 1467218552
Entity type: Organization (Type 2)
Issued: Feb 26, 2024
Last updated: Feb 26, 2024
Status: Active
Subpart: Yes of Id Oms Specialty Dental Services, PLLC

Other names

Boise Oral Surgery & Implant Center · doing business as

Authorized official

Charlotte Dasch
Director of Credentialing and PR
(615) 678-0759

Verify this record

This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

Is this your record? How to update it.

About NPI 1467218552

Id Oms Specialty Dental Services, PLLC's National Provider Identifier is 1467218552, issued on Feb 26, 2024. The primary taxonomy on file is Oral and Maxillofacial Surgery (Dentist) (1223S0112X), and the practice location is in Boise, ID. The record was last updated on Feb 26, 2024.