# RETINA SPECIALISTS OF IDAHO PARTNERS, PLLC

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

## Provider details

- **NPI number:** 1922425032
- **Authorized official:** DENTON R. ROBERTS MD (MANAGING PARTNER)
- **Authorized official phone:** (208) 938-5624

## Contact information

- **Practice address:** 13923 W WAINWRIGHT DR, SUITE 301, BOISE, ID 83713-1969
- **Practice address phone:** (208) 938-5624
- **Practice address fax:** (208) 938-5764
- **Mailing address:** 13923 W WAINWRIGHT DR, SUITE 301, BOISE, ID 83713-1969
- **Mailing address phone:** (208) 938-5624
- **Mailing address fax:** (208) 938-5764

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207WX0107X | Retina Specialist (Ophthalmology) Physician | — | NULL | Yes |
| 207WX0107X | Retina Specialist (Ophthalmology) Physician | — | — | Yes |

## Other

- **Enumeration date:** 03/26/2014
- **Last updated:** 10/14/2019