# CORNERSTONE FAMILY DENTAL PLLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1013374461
- **Authorized official:** MR. THOMAS D SNARR D.D.S (OWNER)
- **Authorized official phone:** (208) 356-4240

## Contact information

- **Practice address:** 44 S CENTER ST, REXBURG, ID 83440-3016
- **Practice address phone:** (208) 356-4240
- **Practice address fax:** (208) 356-5361
- **Mailing address:** 44 S CENTER ST, REXBURG, ID 83440-3016
- **Mailing address phone:** (208) 356-4240
- **Mailing address fax:** (208) 356-5361

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | — | NULL | Yes |
| 122300000X | Dentist | — | — | Yes |

## Other

- **Enumeration date:** 01/15/2016
- **Last updated:** 01/15/2016

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 9196514 | — | ID |