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General NPI Number Information
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NPI Number | 1649651464
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Entity Type | Individual
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Provider Name | ANDREA DAWN HANEY DDS
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Gender | Female
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Dates
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Enumeration Date | 06/17/2015
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Last Update Date | 01/15/2025
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Provider Practice Location Address
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Address Line | 7235 W EMERALD ST STE B
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City | BOISE
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State | ID
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Zip | 83704-8600
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Country | US
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Telephone | 208-327-0337
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Fax | 208-376-0468
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Provider Business Mailing Address
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Address Line | 7325 W EMERALD STREET SUITE B
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City | BOISE
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State | ID
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Zip | 83704
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Country | US
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Telephone | 208-327-0337
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | D4661
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License Number State | ID
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