Organization
STONE RIDGE DENTAL P.C.
Active
Other names
Blackfoot Family Dentistry
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CURTIS CARPENTER D.D.S. (PRESIDENT)
(208) 357-7900
Entity
Organization
Contact information
Practice address
380 W JUDICIAL ST, BLACKFOOT, ID 83221-2122
(208) 785-6833
Mailing address
380 W JUDICIAL ST, BLACKFOOT, ID 83221-2122
(208) 785-6833
Taxonomy
Speciality
Code
Description
License number
State
305R00000X
Preferred Provider Organization
Primary
D-4169
ID
Other
Enumeration date
01/14/2013
Last updated
01/14/2013
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