# SILVER LAKE DENTAL PLLC

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

## Provider details

- **NPI number:** 1851551345
- **Authorized official:** MR. JAMES S HOUGH DDS (OWNER)
- **Authorized official phone:** (208) 762-3027

## Contact information

- **Practice address:** 6176 N GOVERNMENT WAY, DALTON GARDENS, ID 83815-7331
- **Practice address phone:** (208) 762-3027
- **Practice address fax:** (208) 762-0531
- **Mailing address:** 6176 N GOVERNMENT WAY, DALTON GARDENS, ID 83815-7331
- **Mailing address phone:** (208) 762-3027
- **Mailing address fax:** (208) 762-0531

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | D3104 | ID | Yes |

## Other

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

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 1223G0001X | GENERAL PRACTICE DENTIST | ID |