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Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

WHITEWATER ORAL SURGERY GROUP PLLC

Active Organization

WHITEWATER ORAL SURGERY GROUP PLLC is a Oral & Maxillofacial Surgery organization located in BOISE, Idaho. NPI 1104248053 is currently active in the NPPES registry. Verify at CMS.

Oral & Maxillofacial Surgery · BOISE, ID

Registration Details

NPI Number
1104248053
Provider Type
Organization
NPI Issued
Jan 13, 2014 (12.609834398008 yrs)
Last Updated
Sep 4, 2020
Licenses
M7750 (ID)
D3407 (ID)

Practice Information

Address
3003 W MAIN ST STE 130
BOISE, ID, 837022026
Browse ID providers · Browse ZIP 83702
Phone
2083427610
Fax
2083441799
Primary Specialty
Oral & Maxillofacial Surgery
1223S0112X
Additional Specialty
Oral & Maxillofacial Surgery
Data sourced from the NPPES National Provider Identifier registry. Healthcare organizations registered in NPPES are assigned an NPI number for use in insurance billing and claims. This information is for informational purposes only. For official verification, use the NPPES NPI Registry.