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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