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Organization

STONE RIDGE SUGAR CITY DBA STONE RIDGE DENTAL

Active
Parent organization
STONE RIDGE DENTAL
Organization subpart
Yes

Provider details

NPI number
Legal business name
STONE RIDGE DENTAL
Authorized official
DR. CURTIS CARPENTER D.D.S. (OWNER/PRESIDENT)
(208) 656-2000
Entity
Organization

Contact information

Practice address
3 E CENTER ST, SUGAR CITY, ID 83448-1247
(208) 656-2000
Mailing address
3 E CENTER ST, SUGAR CITY, ID 83448-1247
(208) 656-2000

Taxonomy

Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
D-4169
ID

Other

Enumeration date
06/23/2016
Last updated
06/23/2016
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