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General NPI Number Information
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NPI Number | 1588825913
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Entity Type | Organization
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Legal Business Name | RYON G. SCHOFIELD DDS, PC
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Dates
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Enumeration Date | 06/18/2008
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Last Update Date | 06/18/2008
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Provider Practice Location Address
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Address Line | 8912 N HESS ST
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City | HAYDEN
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State | ID
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Zip | 83835-9183
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Country | US
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Telephone | 208-762-4331
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Fax | 208-762-7488
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Provider Business Mailing Address
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Address Line | PO BOX 1688
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City | HAYDEN
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State | ID
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Zip | 83835-1688
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Country | US
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Telephone | 208-762-4331
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. RYON GRANT SCHOFIELD
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Credential | D.D.S.
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Telephone | 208-762-4331
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | D3644
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License Number State | ID
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