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

RANDY DEMETTER, DDS

Active Sole Proprietor

RANDY DEMETTER, DDS is a Periodontology healthcare provider located in BOISE, Idaho. NPI 1275941288 is currently active in the NPPES registry. Verify at CMS.

Periodontology · BOISE, ID

Registration Details

NPI Number
1275941288
Provider Type
Individual
Gender
Male
NPI Issued
Jul 23, 2014 (12.085621342646 yrs)
Last Updated
Apr 5, 2023
Licenses
ETN283 (TX)
D-4831-PE (ID)
Sole Proprietor
Yes

Practice Information

Address
140 E BOISE AVE
BOISE, ID, 837064302
Browse ID providers · Browse ZIP 83706
Phone
2083859228
Primary Specialty
Periodontology
1223P0300X
Additional Specialty
Periodontology

Other Periodontology Providers in BOISE, ID

Name Credential NPI
DR. JACK H LINCKS DDS, MS 1346224458
DR. JOHN HOWELL MUMFORD D.M.D. 1639149057
MICHAEL JOHN FLORENCE DMD 1235147281
DR. BRADLEY LYNN TOWNSEND DDS 1700994852
KENNETH G. SHERMAN II DDS 1245310036
RICHARD E FERGUSON D.D.S., M.S. 1710050943
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.