Individual
STEPHEN FREDERICK SCHENK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S., M.S.
Contact information
Practice address
1228 N COLE RD, BOISE, ID 83704-8646
(208) 375-9480
(208) 375-6804
Mailing address
1228 N COLE RD, BOISE, ID 83704-8646
(208) 375-9480
(208) 375-6804
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
D-4242-PE
ID
Other
Enumeration date
03/28/2008
Last updated
07/28/2009
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