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General NPI Number Information
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NPI Number | 1699614503
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Entity Type | Organization
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Legal Business Name | BOISE FAMILY DENTAL OVERLAND
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Dates
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Enumeration Date | 03/26/2026
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Last Update Date | 03/26/2026
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Provider Practice Location Address
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Address Line | 9931 W CABLE CAR STE 150
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City | BOISE
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State | ID
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Zip | 83709-1269
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Country | US
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Telephone | 208-376-7413
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Fax | 208-376-7413
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Provider Business Mailing Address
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Address Line | 6363 W EMERALD ST STE 102
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City | BOISE
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State | ID
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Zip | 83704-8783
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Country | US
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Telephone | 208-376-7413
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Fax | 208-376-7428
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Authorized Official
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Title or Position | DENTIST/OWNER
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Name | DR. STEVEN CRUMP
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Credential | DMD
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Telephone | 208-546-2525
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number |
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License Number State |
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