Individual
DR. CARSON STEVEN DIAL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
10661 W STATE ST, STAR, ID 83669-5924
(208) 286-9890
Mailing address
10661 W STATE ST, STAR, ID 83669-5924
(082) 286-9890
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
D-4757
ID
1223G0001X
General Practice Dentistry
D-4757
ID
Other
Enumeration date
06/15/2016
Last updated
03/04/2024
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