Individual
CALEB EDWARD STOTT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
467 S. RIVERSHORE LANE, EAGLE, ID 83616-4978
(208) 792-6473
(208) 975-7041
Mailing address
467 S. RIVERSHORE LANE, EAGLE, ID 83616-4978
(208) 792-6473
(208) 975-7041
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
D5494
ID
1223G0001X
General Practice Dentistry
8014319-9921
UT
Other
Enumeration date
06/09/2015
Last updated
06/06/2024
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