Organization
BOISE VALLEY ORTHODONTICS PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRENDON JAMES SWENSON DDS, MS (MANAGER)
(208) 649-5721
Entity
Organization
Contact information
Practice address
4111 CLOCK TOWER AVE, CALDWELL, ID 83607-5006
(208) 649-5721
Mailing address
4111 CLOCK TOWER AVE, CALDWELL, ID 83607-5006
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
—
—
Other
Enumeration date
02/08/2016
Last updated
02/27/2016
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