# HIDDEN SPRINGS DENTAL PLLC

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

## Provider details

- **NPI number:** 1760661482
- **Authorized official:** MRS. JAYNE BLAZEK (OFFICE MANAGER)
- **Authorized official phone:** (208) 228-4900

## Contact information

- **Practice address:** 5833 W HIDDEN SPRINGS DR, BOISE, ID 83714-9453
- **Practice address phone:** (208) 229-4900
- **Practice address fax:** (208) 229-4902
- **Mailing address:** 5833 W HIDDEN SPRINGS DR, BOISE, ID 83714-9453
- **Mailing address phone:** (208) 229-4900
- **Mailing address fax:** (208) 229-4902

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | D1992 | ID | Yes |
| 1223G0001X | General Practice Dentistry | D3281 | ID | — |

## Other

- **Enumeration date:** 10/30/2007
- **Last updated:** 10/30/2007