Individual
DR. ANDREW R STUCKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
465 MEMORIAL DR, POCATELLO, ID 83201-4008
(208) 282-6000
Mailing address
465 MEMORIAL DR, POCATELLO, ID 83201-4008
(208) 282-6000
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D-4842
ID
Other
Enumeration date
07/03/2017
Last updated
07/21/2022
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