Organization
STILSON DENTAL PARTNERSHIP PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TYSON N GRAY DMD (MANAGING PARTNER)
(208) 342-4644
Entity
Organization
Contact information
Practice address
813 N STILSON RD STE B, BOISE, ID 83703-5119
(208) 342-4644
(208) 375-2008
Mailing address
813 N STILSON RD STE B, BOISE, ID 83703-5119
(208) 342-4644
(208) 375-2008
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
3799
ID
Other
Enumeration date
10/26/2017
Last updated
10/26/2017
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