Individual
DIANA STEPANOVA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
2344 N MERRITT CREEK LOOP, COEUR D ALENE, ID 83814-4950
(208) 457-7137
Mailing address
791 E SOUTHWOOD CT, HAYDEN, ID 83835-6960
(208) 957-4675
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D-5630
ID
Other
Enumeration date
06/11/2024
Last updated
06/15/2024
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