| 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 |