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1336224633
G. VAN STOSICH
IDAHO FALLS, ID
NPI
1336224633
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
1223G0001X Dentist, General Practice
(Licence: ID D-1730)
Enumeration Date
2006-10-26
Last Update Date
2023-03-07
Business Address
-- G. VAN STOSICH D.D.S.
1400 E 17TH ST
IDAHO FALLS, ID 83404-6269
Phone number: 208-522-8061
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Mailing Address
-- G. VAN STOSICH D.D.S.
1400 E 17TH ST
IDAHO FALLS, ID 83404-6269
Phone number: 208-522-8061
Copy
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