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Organization

JASON CHAMPAGNE IDAHO 1, PLLC

Active
Other names
Emerald West Family Dentistry
Organization subpart
No

Provider details

NPI number
Authorized official
JASON CHAMPAGNE DDS (OWNER)
(775) 359-3934
Entity
Organization

Contact information

Practice address
8850 W EMERALD ST STE 150, BOISE, ID 83704-4809
(208) 323-2294
Mailing address
PO BOX 2070, SPARKS, NV 89432-2070

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary

Other

Enumeration date
05/09/2024
Last updated
05/09/2024
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