# IDAHO ENDODONTICS PA

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Herbert R Blaser DDS PA
- **Organization subpart:** No

## Provider details

- **NPI number:** 1417096678
- **Authorized official:** DR. HERBERT R BLASER DDS (PRES)
- **Authorized official phone:** (208) 376-9280

## Contact information

- **Practice address:** 2014 N COLE RD, BOISE, ID 83704
- **Practice address phone:** (208) 376-9280
- **Practice address fax:** (208) 376-9280
- **Mailing address:** 2014 N COLE RD, BOISE, ID 83704
- **Mailing address phone:** (208) 376-9280
- **Mailing address fax:** (208) 376-9280

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223E0200X | Endodontics | 66D1481EN | ID | Yes |

## Other

- **Enumeration date:** 02/05/2007
- **Last updated:** 08/22/2020