Kss Dental Group Pllc

NPI #1457704009 in Caldwell, Idaho

Provider Information

NPI Number: 1457704009
Entity Type: Organization
Organization Name: Kss Dental Group Pllc
Subpart: Yes (part of a larger organization)
Parent Organization: KSS DENTAL GROUP PLLC
Primary Specialty: Dentist - General Practice
Enumeration Date: Jul 19, 2016
Last Updated: Jul 19, 2016

Practice Location

Address: 329 E LOGAN ST
City: Caldwell
State: Idaho
ZIP Code: 83605-4863
Phone: (208) 459-3388

Authorized Official

Name: DR. KEITH L STUCKI, DMD
Title: MANAGER
Phone: (208) 459-3388

Specialties & Taxonomy Codes

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

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