# WEST VALLEY ENDODONTICS

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

## Provider details

- **NPI number:** 1952055840
- **Authorized official:** MICHELLE HYMAS (OFFICE ADMINISTRATOR)
- **Authorized official phone:** (208) 841-7810

## Contact information

- **Practice address:** 3308 N MILWAUKEE ST, BOISE, ID 83704-4447
- **Practice address phone:** (208) 323-1990
- **Practice address fax:** (208) 323-1990
- **Mailing address:** 3308 N MILWAUKEE ST, BOISE, ID 83704-4447

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223E0200X | Endodontics | — | — | Yes |

## Other

- **Enumeration date:** 02/09/2022
- **Last updated:** 02/09/2022