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Stilson Dental Partnership PLLC

Dentist, General Practice in Boise, ID. Organization (NPI-2).

NPI number1669984902
StatusActive
Last updated in NPPESOct 26, 2017

Details

NPI
1669984902
Entity type
Organization (NPI-2)
Legal business name
Stilson Dental Partnership PLLC
Organization subpart
No
Enumeration date
Oct 26, 2017
Last updated
Oct 26, 2017

Medicare and OIG

Medicare enrolled (PECOS)
Not in the Medicare enrollment file
Can order and refer
Not on the CMS order and referring list
OIG exclusion list
This NPI is not listed

CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
1223G0001X Dentist, General Practice3799IDYes

Practice location

813 N Stilson Rd Ste B
Boise, ID 83703-5119

Phone 208-342-4644 · Fax 208-375-2008

Mailing address

813 N Stilson Rd Ste B
Boise, ID 83703-5119

Phone 208-342-4644 · Fax 208-375-2008

Authorized official

Tyson N Gray
Managing Partner
2083424644

Is something wrong?

This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.

Other General Practice Dentistry providers in Boise, ID

All 220 General Practice Dentistry providers in Boise · All 12,265 providers in Boise

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