Individual
DENNIS G STODDARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
625 E ALAMEDA RD, POCATELLO, ID 83201-3622
(208) 237-1567
Mailing address
2295 S CHAMBERS RD, #E, AURORA, CO 80014-4544
(303) 751-6511
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
8647
CO
1223G0001X
General Practice Dentistry
8647
CO
1223P0221X
Pediatric Dentistry
Primary
D-4186-PD
ID
Other
Enumeration date
05/29/2007
Last updated
11/12/2024
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