Organization
STONE CREEK DENTAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CASEY SCOTT BUTTERFIELD DDS (OWNER)
(208) 888-0625
Entity
Organization
Contact information
Practice address
2630 S EAGLE RD, MERIDIAN, ID 83642-6704
(208) 888-0625
(208) 888-9128
Mailing address
2630 S EAGLE RD, MERIDIAN, ID 83642-6704
(208) 888-0625
(208) 888-9128
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D3806
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
001821391
UNITED CONCORDIA
—
Enumeration date
06/02/2008
Last updated
06/02/2008
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