Stone Ridge Dental Inc.

NPI #1558512277 in Shelley, Idaho

Provider Information

NPI Number
1558512277
Entity Type
Organization
Organization Name
Stone Ridge Dental Inc.
Primary Specialty
Preferred Provider Organization
Enumeration Date
Oct 1, 2008
Last Updated
Oct 1, 2008

Practice Location

Address
1035 OCTOBER CV
State
Idaho
ZIP Code
83274-5068
Phone
(208) 357-0307

Authorized Official

Name
CURTIS CARPENTER, D.D.S.
Title
OWNER
Phone
(208) 346-7045

Specialties & Taxonomy Codes

Specialty
Preferred Provider Organization

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