Hidden Creek Dental, Pllc

NPI #1396554762 in Boise, Idaho

Provider Information

NPI Number: 1396554762
Entity Type: Organization
Organization Name: Hidden Creek Dental, Pllc
Primary Specialty: Dentist - General Practice
Enumeration Date: Dec 31, 2024
Last Updated: Dec 31, 2024

Practice Location

Address: 580 W PARKCENTER BLVD
City: Boise
State: Idaho
ZIP Code: 83706-3659
Phone: (208) 336-8478

Authorized Official

Name: DR. RYAN JAMES CLARK, DDS
Title: SOLE OWNER/DENTIST
Phone: (208) 336-8478

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist - General Practice — General Practice	1223G0001X	Primary

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