Search › Idaho › 1223P0300X
Randy Demetter, DDS
NPI 1275941288 · on the registry since 2014 · sole proprietor
Practice
- Address
- 140 E Boise Ave
Boise, ID 83706 - Phone
- (208) 385-9228
- Organisation at this address
- Stephen A. Morris
Periodontal Health Specialists Of IdahoInferred from a shared address, not stated in the registry. - Clinicians at this address
- 6
Additional practice sites
- 347 W Iowa Ave, Nampa, ID
Registry record
- Primary taxonomy
- 1223P0300X
1223P0300X
- Also registered as
- 1223P0300X
- Licence states on file
- TX, ID
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2023-04-05
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Idaho