# JAMES A. GORCZYCA DDS PA

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1568622876
- **Authorized official:** SHELLEY FANNIN (ACCOUNTS MANAGER)
- **Authorized official phone:** (208) 342-0315

## Contact information

- **Practice address:** 144 E MALLARD DR, BOISE, ID 83706-3975
- **Practice address phone:** (208) 342-0315
- **Mailing address:** 144 E MALLARD DR, BOISE, ID 83706-3975
- **Mailing address phone:** (208) 342-0315

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | D-1672 | ID | Yes |

## Other

- **Enumeration date:** 06/10/2008
- **Last updated:** 06/10/2008

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 002485600 | — | ID |