Organization
TREASURE VALLEY ENDODONTICS, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STANTON WIDMER (OWNER)
(208) 454-3636
Entity
Organization
Contact information
Practice address
4207 CLOCK TOWER AVE STE 101, CALDWELL, ID 83607-5236
(208) 454-3636
Mailing address
4207 CLOCK TOWER AVE STE 101, CALDWELL, ID 83607-5236
Taxonomy
Speciality
Code
Description
License number
State
1223E0200X
Endodontics
Primary
—
—
Other
Enumeration date
11/13/2024
Last updated
11/13/2024
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