| Braden M. Stauts Dds Llc | |
|
1000 N Curtis Rd Suite 203 Boise ID 83706-1337 | |
| (208) 376-0567 | |
| Not Available |
| Full Name | Braden M. Stauts Dds Llc |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 1000 N Curtis Rd, Boise, Idaho |
| Authorized Official Name and Position | Braden M Stauts (OWNER) |
| Authorized Official Contact | 2083760567 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Braden M. Stauts Dds Llc 1000 N Curtis Rd Suite 203 Boise ID 83706-1337 Ph: (208) 376-0567 | Braden M. Stauts Dds Llc 1000 N Curtis Rd Suite 203 Boise ID 83706-1337 Ph: (208) 376-0567 |
| NPI Number | 1386899987 |
|---|---|
| Provider Enumeration Date | 11/24/2008 |
| Last Update Date | 11/24/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1386899987 | NPI | - | NPPES |
| 1578588364 | Other | ID | PERSONAL NPI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | D-2083-PR (Idaho) | Primary |
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