# STOCK & GARN LLP

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

## Provider details

- **NPI number:** 1265607311
- **Authorized official:** MRS. ELAINE ANNETTE HANSEN (OFFICE MANAGER)
- **Authorized official phone:** (208) 678-8188

## Contact information

- **Practice address:** 2200 PARK AVE, SUITE 2, BURLEY, ID 83318-2186
- **Practice address phone:** (208) 678-8188
- **Practice address fax:** (208) 678-3170
- **Mailing address:** 2200 PARK AVE, SUITE 2, BURLEY, ID 83318-2186
- **Mailing address phone:** (208) 678-8188
- **Mailing address fax:** (208) 678-3170

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | — | — | Yes |

## Other

- **Enumeration date:** 04/29/2008
- **Last updated:** 04/29/2008

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 002656300 | — | ID |
| 05 | — | 804002700 | — | ID |