| Andrew Stoddard Dental Services, Pllc | |
|
1525 Baldy Ave Pocatello ID 83201-7117 | |
| (208) 238-0011 | |
| Not Available |
| Full Name | Andrew Stoddard Dental Services, Pllc |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 1525 Baldy Ave, Pocatello, Idaho |
| Authorized Official Name and Position | Andrew Stoddard (SOLE MEMBER) |
| Authorized Official Contact | 2082380011 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Andrew Stoddard Dental Services, Pllc 1525 Baldy Ave Pocatello ID 83201-7117 Ph: () - | Andrew Stoddard Dental Services, Pllc 1525 Baldy Ave Pocatello ID 83201-7117 Ph: (208) 238-0011 |
| NPI Number | 1346501657 |
|---|---|
| Provider Enumeration Date | 06/04/2012 |
| Last Update Date | 06/04/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1346501657 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | D-4149 (Idaho) | Primary |
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