Individual
MRS. SHANNON MICHELLE STETZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RDH
Contact information
Practice address
500 W FORT ST, BOISE, ID 83702-4501
(208) 422-1000
Mailing address
10530 W STARDUST DR, BOISE, ID 83709-0367
(208) 406-7440
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
D5980
OR
124Q00000X
Dental Hygienist
Primary
DH2281
ID
Other
Enumeration date
08/08/2016
Last updated
06/10/2022
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