Dallas Stevens Od PA

NPI #1477053007 in Boise, Idaho

Provider Information

NPI Number: 1477053007
Entity Type: Organization
Organization Name: Dallas Stevens Od PA
Primary Specialty: Optometrist
Enumeration Date: Feb 20, 2018
Last Updated: Feb 20, 2018

Practice Location

Address: 8359 W EMERALD ST
City: Boise
State: Idaho
ZIP Code: 83704-8304
Phone: (209) 376-2062

Authorized Official

Name: DALLAS STEVENS, OD PA
Title: OPTOMETRIST/ OWNER
Phone: (208) 376-2062

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Optometrist	152W00000X	Primary

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