# MATTHEW TUFT DENTAL LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Copperstone Dental
- **Organization subpart:** No

## Provider details

- **NPI number:** 1417285354
- **Authorized official:** MRS. LINDA STERLING (OFFICE MANAGER)
- **Authorized official phone:** (208) 376-5499

## Contact information

- **Practice address:** 12426 W EXPLORER DR, STE 210, BOISE, ID 83713-1572
- **Practice address phone:** (208) 376-5499
- **Practice address fax:** (208) 376-5527
- **Mailing address:** 12426 W EXPLORER DR, STE 210, BOISE, ID 83713-1572
- **Mailing address phone:** (208) 376-5499
- **Mailing address fax:** (208) 376-5527

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | D4053 | ID | Yes |

## Other

- **Enumeration date:** 12/04/2009
- **Last updated:** 12/04/2009

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 807788800 | — | ID |