Individual
DR. BRADEN M STAUTS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
1000 N CURTIS RD, SUITE 203, BOISE, ID 83706-1337
(208) 376-0567
(208) 376-0661
Mailing address
1000 N CURTIS RD, SUITE 203, BOISE, ID 83706-1337
(208) 376-0567
(208) 376-0661
Taxonomy
Speciality
Code
Description
License number
State
1223P0700X
Prosthodontics
Primary
D-2083-PR
ID
Other
Enumeration date
07/13/2006
Last updated
07/08/2007
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