Individual
DR. STEPHEN PHILIP GLOUDEMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
105 E 10TH AVE, POST FALLS, ID 83854-5125
(208) 773-8388
Mailing address
105 E 10TH AVE, POST FALLS, ID 83854-5125
(208) 773-8388
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D5526
ID
Other
Enumeration date
06/06/2023
Last updated
06/06/2023
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