# TROY A. CLOVIS DMD

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- **Entity:** Organization
- **Status:** Active
- **Other names:** BENCHMARK FAMILY DENTISTRY
- **Organization subpart:** No

## Provider details

- **NPI number:** 1407015613
- **Authorized official:** MS. SUZANNE B MOONEY (BOOKKEEPER)
- **Authorized official phone:** (208) 376-2726

## Contact information

- **Practice address:** 4552 N CLOVERDALE RD, BOISE, ID 83713-2417
- **Practice address phone:** (208) 376-2726
- **Practice address fax:** (208) 376-6401
- **Mailing address:** 4552 N CLOVERDALE RD, BOISE, ID 83713-2417
- **Mailing address phone:** (208) 376-2726
- **Mailing address fax:** (208) 376-6401

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | D3039 | ID | Yes |

## Other

- **Enumeration date:** 06/03/2008
- **Last updated:** 06/03/2008

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 6100-2 | BLUE CROSS OF IDAHO | ID |
| 01 | — | 62644 | UNITED CONCORDIA | ID |
| 05 | — | 66D3039 | — | ID |