Stone Ridge Sugar City Dba Stone Ridge Dental | |
3 E Center St Sugar City ID 83448-1247 | |
(208) 656-2000 | |
Not Available |
Full Name | Stone Ridge Sugar City Dba Stone Ridge Dental |
---|---|
Speciality | Clinic/center - Dental |
Location | 3 E Center St, Sugar City, Idaho |
Authorized Official Name and Position | Curtis Carpenter (OWNER/PRESIDENT) |
Authorized Official Contact | 2086562000 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Stone Ridge Sugar City Dba Stone Ridge Dental 3 E Center St Sugar City ID 83448-1247 Ph: (208) 656-2000 | Stone Ridge Sugar City Dba Stone Ridge Dental 3 E Center St Sugar City ID 83448-1247 Ph: (208) 656-2000 |
NPI Number | 1881045698 |
---|---|
Provider Enumeration Date | 06/23/2016 |
Last Update Date | 06/23/2016 |
Identifier | Type | State | Issuer |
---|---|---|---|
1881045698 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QD0000X | Clinic/center - Dental | D-4169 (Idaho) | Primary |