Organization
BOISE TOOTHTOWN DENTISTRY FOR KIDS PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DENNIS GARTH STODDARD DMD (OWNER)
(208) 453-6188
Entity
Organization
Contact information
Practice address
13014 W PERSIMMON LN, BOISE, ID 83713-1986
(208) 377-2072
(208) 376-7580
Mailing address
13014 W PERSIMMON LN, BOISE, ID 83713-1986
(208) 377-2072
(208) 376-7580
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
D4031
ID
1223P0221X
Pediatric Dentistry
Primary
D4186PD
ID
Other
Enumeration date
07/14/2016
Last updated
07/14/2016
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