Andrew Stoddard Dental Services, PLLC

Organization Active NPI Dental Clinic/Center · Pocatello, ID

NPI 1346501657 · NPPES record last updated Jun 4, 2012

Key facts

NPI
1346501657
Entity type
Organization (NPI type 2)
Primary specialty
Dental Clinic/Center 261QD0000X
License
D-4149 (ID)
Legal business name
ANDREW STODDARD DENTAL SERVICES, PLLC
Practice address
1525 Baldy Ave
Pocatello, ID 83201-7117
Phone
(208) 238-0011
NPI assigned
Jun 4, 2012
Organization subpart
No

Authorized official

Name
Andrew Stoddard, DDS
Title
Sole Member
Phone
(208) 238-0011

National Provider Directory

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X D-4149 ID Yes

Addresses

Primary practice location

1525 Baldy Ave
Pocatello, ID 83201-7117

Mailing address

1525 Baldy Ave
Pocatello, ID 83201-7117

Other providers in Pocatello, ID

All providers in Pocatello, ID · Dental Clinic/Center in Idaho

Sources for this page

Verify at the official NPI Registry.