# BOISE ORAL AND MAXILLOFACIAL SURGERY

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

## Provider details

- **NPI number:** 1699949750
- **Authorized official:** DR. KEVIN KEMPERS DDS/MD (OWNER)
- **Authorized official phone:** (208) 376-4550

## Contact information

- **Practice address:** 6363 W EMERALD ST, SUITE 103, BOISE, ID 83704-8783
- **Practice address phone:** (208) 376-4550
- **Practice address fax:** (208) 376-4552
- **Mailing address:** 6363 W EMERALD ST, SUITE 103, BOISE, ID 83704-8783
- **Mailing address phone:** (208) 376-4550
- **Mailing address fax:** (208) 376-4552

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | D-3407 | ID | Yes |

## Other

- **Enumeration date:** 04/18/2008
- **Last updated:** 04/18/2008