Robert O Stevens Dmd, PA

NPI #1336220144 in Boise, Idaho

Provider Information

NPI Number: 1336220144
Entity Type: Organization
Organization Name: Robert O Stevens Dmd, PA
Primary Specialty: Clinic/Center - Dental
Enumeration Date: Oct 18, 2006
Last Updated: May 13, 2013

Practice Location

Address: 10572 W BUSINESS PARK LN
City: Boise
State: Idaho
ZIP Code: 83709-6797
Phone: (208) 375-5656

Authorized Official

Name: DR. ROBERT ORLO STEVENS
Title: DENTIST OWNER
Phone: (208) 375-5656

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Clinic/Center - Dental — Dental	261QD0000X	Primary

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