Provider Demographics
NPI:1972023398
Name:NORTHVIEW DENTAL PARTNERSHIP LLC
Entity Type:Organization
Organization Name:NORTHVIEW DENTAL PARTNERSHIP LLC
Other - Org Name:PARKWAY DENTAL AT NORTHVIEW
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:KARLA
Authorized Official - Middle Name:LOUISE
Authorized Official - Last Name:PICCIOTTI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:208-342-4644
Mailing Address - Street 1:7480 NORTHVIEW ST.
Mailing Address - Street 2:
Mailing Address - City:BOISE
Mailing Address - State:ID
Mailing Address - Zip Code:83704
Mailing Address - Country:US
Mailing Address - Phone:208-375-0607
Mailing Address - Fax:208-375-8208
Practice Address - Street 1:7480 W NORTHVIEW ST
Practice Address - Street 2:
Practice Address - City:BOISE
Practice Address - State:ID
Practice Address - Zip Code:83704-7232
Practice Address - Country:US
Practice Address - Phone:208-375-0607
Practice Address - Fax:208-375-8208
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-06-27
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty