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Organization
MATTHEW TUFT DENTAL LLC
Active
Organization
MATTHEW TUFT DENTAL LLC
Active
Other names
Copperstone Dental
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. LINDA STERLING (OFFICE MANAGER)
(208) 376-5499
Entity
Organization
Contact information
Practice address
12426 W EXPLORER DR, STE 210, BOISE, ID 83713-1572
(208) 376-5499
(208) 376-5527
Mailing address
12426 W EXPLORER DR, STE 210, BOISE, ID 83713-1572
(208) 376-5499
(208) 376-5527
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D4053
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
807788800
—
ID
Enumeration date
12/04/2009
Last updated
12/04/2009
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