Nathan Gary Bourassa, DDS

General Practice Dentistry · Post Falls, ID

Individual Active NPI

NPI number 1669662995

Practice location

105 E 10TH Ave Ste B
Post Falls, ID 83854-5125

Phone: (208) 773-8388
Fax: (208) 777-0346

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NPI record

NPI: 1669662995
Entity type: Individual (Type 1)
Enumeration date: August 1, 2007
Last updated: August 1, 2007
Sole proprietor: Yes

Specialties & taxonomy codes

Taxonomy	Code	License	State
General Practice Dentistry Primary	`1223G0001X`	D-4076	ID

About Dr. Bourassa

Nathan Gary Bourassa, DDS is a healthcare provider registered in the NPI registry with the primary taxonomy General Practice Dentistry (code 1223G0001X). The practice location is 105 E 10TH Ave Ste B, Post Falls, ID 83854-5125. The NPI number 1669662995 was assigned on August 1, 2007 and the record was last updated on August 1, 2007.

Dr. Bourassa lists a license in the registry: #D-4076 (ID) for General Practice Dentistry. License numbers are self-reported to NPPES; verify them with the state licensing board.

Frequently asked questions

What is the NPI number of Nathan Gary Bourassa, DDS?

The NPI number is 1669662995.

What is the phone number of Dr. Bourassa?

The phone number listed for the practice location is (208) 773-8388.

Where is Dr. Bourassa located?

105 E 10TH Ave Ste B, Post Falls, ID 83854-5125.

What is the taxonomy code for Dr. Bourassa?

The primary taxonomy code is 1223G0001X – General Practice Dentistry.

Is this information correct?

All details come from the public NPPES registry. Providers can update their record at nppes.cms.hhs.gov; changes appear here after the next weekly update.