Organization
PARKCENTER ORAL AND MAXILLOFACIAL SURGERY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. STUART J RUPP DMD (OWNER)
(208) 553-6813
Entity
Organization
Contact information
Practice address
3190 E BARBER VALLEY DR, BOISE, ID 83716
(208) 715-5219
(208) 504-2771
Mailing address
3190 E BARBER VALLEY DR, BOISE, ID 83716
(208) 715-5219
(208) 504-2771
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
—
—
Other
Enumeration date
08/09/2023
Last updated
10/20/2023
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