Organization
JASON CHAMPAGNE IDAHO 3, PLLC
Active
Other names
Greentree Dental Boise
Organization subpart
No
Provider details
NPI number
Authorized official
JASON CHAMPAGNE DDS (OWNER)
(775) 359-3934
Entity
Organization
Contact information
Practice address
2600 W ROSE HILL ST STE 100, BOISE, ID 83705-5900
(208) 345-1386
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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