Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Idaho Perio Center for Dental Implants & Laser Periodontal Therapy

Organization Periodontics · NPI 1194175232

Idaho Perio Center for Dental Implants & Laser Periodontal Therapy is a Periodontics in Boise, Idaho. Licensed in Idaho. Registered with an NPI since 2016.

Licensed in
ID
In the registry since
2016

Practice location Address checks out

6019 N Eagle Rd
Boise, ID 83713-0997
Phone: (208) 377-2777
Fax: (208) 377-3075
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Periodontics (primary) Taxonomy 1223P0300X · Licence D-4290 (ID)

Record details

NPI number1194175232
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Jace Hansen — Owner · (208) 377-2777
NPI enumeratedJune 20, 2016
Last updated in NPPESJune 20, 2016
Mailing address6019 N Eagle Rd, Boise, ID 83713-0997

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