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Organization
GLEN K STEPHENSON DMD CHARTERED
Active
Organization
GLEN K STEPHENSON DMD CHARTERED
Active
Other names
Prevention Dental
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GLEN K STEPHENSON DMD (PRESIDENT)
(208) 375-4041
Entity
Organization
Contact information
Practice address
7480 NORTHVIEW ST, BOISE, ID 83704-7232
(208) 375-4041
(208) 375-0225
Mailing address
7480 NORTHVIEW ST, BOISE, ID 83704-7232
(208) 375-4041
(208) 375-0225
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D3338
ID
Other
Enumeration date
06/12/2008
Last updated
06/12/2008
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