Jason Champagne Idaho 3, Pllc

NPI #1609624139 in Boise, Idaho

Provider Information

NPI Number: 1609624139
Entity Type: Organization
Organization Name: Jason Champagne Idaho 3, Pllc
Primary Specialty: Dentist - General Practice
Enumeration Date: May 9, 2024
Last Updated: May 9, 2024

Practice Location

Address: 2600 W ROSE HILL ST STE 100
City: Boise
State: Idaho
ZIP Code: 83705-5900
Phone: (208) 345-1386

Authorized Official

Name: JASON CHAMPAGNE, DDS
Title: OWNER
Phone: (775) 359-3934

Specialties & Taxonomy Codes

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

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