Organization
ALLAN W, STEVENSON DDS PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ALLAN WALKER STEVENSON DDS (PRESIDENT)
(208) 722-6400
Entity
Organization
Contact information
Practice address
206 GROVE AVE, PARMA, ID 83660
(208) 722-6400
(208) 722-9016
Mailing address
206 GROVE AVE, PO BOX 420, PARMA, ID 83660
(208) 722-6400
(208) 722-9016
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D3204
ID
Other
Enumeration date
01/10/2007
Last updated
08/22/2020
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