# DENTISTS OF BOISE AND ORTHODONTICS, PC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Dentists of Boise and Orthodontics
- **Organization subpart:** No

## Provider details

- **NPI number:** 1235747338
- **Authorized official:** KEVIN JOHNSON DDS (OWNER)
- **Authorized official phone:** (208) 258-7740

## Contact information

- **Practice address:** 7500 W STATE ST STE 110, BOISE, ID 83714-6074
- **Practice address phone:** (208) 258-7740
- **Practice address fax:** (208) 350-6895
- **Mailing address:** PO BOX 920050, DALLAS, TX 75392-0050
- **Mailing address phone:** (714) 845-8890
- **Mailing address fax:** (303) 852-0892

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | — | — | Yes |

## Other

- **Enumeration date:** 07/15/2020
- **Last updated:** 08/05/2022