G. Van Stosich, D.D.S.
NPI #1336224633 in Idaho Falls, Idaho
Provider Information
- NPI Number
- 1336224633
- Entity Type
- Individual
- Name
- G. Van Stosich, D.D.S.
- Gender
- Not Specified
- Sole Proprietor
- Yes
- Primary Specialty
- Dentist - General Practice
- Credential
- D.D.S.
- Enumeration Date
- Oct 26, 2006
- Last Updated
- Mar 7, 2023
Practice Location
- Address
- 1400 E 17TH ST
- City
- Idaho Falls
- State
- Idaho
- ZIP Code
- 83404-6269
- Phone
- (208) 522-8061
Specialties & Taxonomy Codes
| Specialty |
|---|
| Dentist - General Practice — General Practice |
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