Organization
TREASURE VALLEY PEDIATRIC DENTISTRY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ROY ROGERS DDS (PEDIATRIC DENTIST)
(208) 376-8873
Entity
Organization
Contact information
Practice address
1564 S TIMESQUARE LN, BOISE, ID 83709-8266
(208) 376-8873
(208) 377-8875
Mailing address
1564 S TIMESQUARE LN, BOISE, ID 83709-8266
(208) 376-8873
(208) 377-8875
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
D3725-PD
ID
Other
Enumeration date
02/28/2017
Last updated
02/28/2017
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