Individual
DR. STEPHEN W HOLM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
3326 4TH ST STE 2, LEWISTON, ID 83501-4455
(208) 743-1640
(208) 743-1643
Mailing address
3326 4TH ST STE 2, LEWISTON, ID 83501-4455
(208) 743-1640
(208) 743-1643
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
D-4057
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
808116400
—
ID
01
—
9212066
IDAHO SMILES
ID
Enumeration date
05/28/2008
Last updated
08/03/2009
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