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General NPI Number Information
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NPI Number | 1831982958
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Entity Type | Organization
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Legal Business Name | ROYAL DENTAL PLLC
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Dates
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Enumeration Date | 05/22/2025
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Last Update Date | 05/22/2025
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Provider Practice Location Address
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Address Line | 2398 E GOWEN RD
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City | BOISE
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State | ID
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Zip | 83716-6707
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Country | US
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Telephone | 702-704-5467
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Fax |
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Provider Business Mailing Address
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Address Line | 11496 W PECONIC CT
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City | BOISE
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State | ID
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Zip | 83709-3316
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Country | US
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Telephone | 702-704-5467
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MICHAEL HOWARD ROBINSON
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Credential | DMD
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Telephone | 702-704-5467
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State |
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