| Robert O Stevens Dmd, Pa | |
|
10572 W Business Park Ln Boise ID 83709-6797 | |
| (208) 375-5656 | |
| (208) 375-5928 |
| Full Name | Robert O Stevens Dmd, Pa |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 10572 W Business Park Ln, Boise, Idaho |
| Authorized Official Name and Position | Robert Orlo Stevens (DENTIST OWNER) |
| Authorized Official Contact | 2083755656 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Robert O Stevens Dmd, Pa 10572 W Business Park Ln Boise ID 83709-6797 Ph: (208) 375-5656 | Robert O Stevens Dmd, Pa 10572 W Business Park Ln Boise ID 83709-6797 Ph: (208) 375-5656 |
| NPI Number | 1336220144 |
|---|---|
| Provider Enumeration Date | 10/18/2006 |
| Last Update Date | 05/13/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1336220144 | NPI | - | NPPES |
| 43162 | Other | ID | REGENCE BLUE SHIELD |
| 64709 | Other | ID | BLUE CROSS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | D1807 (Idaho) | Primary |
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