Individual
MICHAEL D STEVENS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
8744 W FAIRVIEW AVE, BOISE, ID 83704-8207
(208) 893-5000
(208) 322-3364
Mailing address
8744W FAIRVIEW AVE, BOISE, ID 83704-8207
(208) 893-5000
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D-4632
ID
Other
Enumeration date
12/14/2009
Last updated
07/06/2016
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