Provider Demographics
NPI:1508038316
Name:HISEL INC
Entity Type:Organization
Organization Name:HISEL INC
Other - Org Name:HISEL INC DBA PARAMOUNT FAMILY DENTISTRY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:E
Authorized Official - Last Name:HISEL
Authorized Official - Suffix:II
Authorized Official - Credentials:DDS
Authorized Official - Phone:208-375-0192
Mailing Address - Street 1:10162 W FAIRVIEW AVE
Mailing Address - Street 2:
Mailing Address - City:BOISE
Mailing Address - State:ID
Mailing Address - Zip Code:83704-8117
Mailing Address - Country:US
Mailing Address - Phone:208-375-0192
Mailing Address - Fax:208-378-7333
Practice Address - Street 1:10162 W FAIRVIEW AVE
Practice Address - Street 2:
Practice Address - City:BOISE
Practice Address - State:ID
Practice Address - Zip Code:83704-8117
Practice Address - Country:US
Practice Address - Phone:208-375-0192
Practice Address - Fax:208-378-7333
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-01
Last Update Date:2008-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty