OrganizationActive
Retina Specialists of Idaho, PLLC
NPI 1366607996 · Ophthalmology Physician · Boise, ID
Provider details
- NPI number
- 1366607996
- Entity type
- Organization
- Primary specialty
- Ophthalmology PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Denton Roberts, Owner(208) 938-5624
- License
- M-10066 (ID)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Practice location
13923 W Wainwright Dr
Suite 301
Boise, ID 83713-1969
Phone: (208) 938-5624
Fax: (208) 938-5764
Approximate (ZIP-level) locationGet directions
Mailing address
13923 W Wainwright Dr
Boise, ID 83713-1969
Registry dates
- Enumerated
- 2008-07-23
- Last updated
- 2012-04-10
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.