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General NPI Number Information
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NPI Number | 1841626710
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Entity Type | Individual
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Provider Name | STEPHEN ANTHONY HUBERT DDS
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Gender | Male
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Dates
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Enumeration Date | 09/23/2013
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Last Update Date | 07/02/2018
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Provider Practice Location Address
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Address Line | 600 E. RIVERPARK LN., STE. 100
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City | BOISE
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State | ID
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Zip | 83706-7237
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Country | US
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Telephone | 208-258-3600
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Fax | 808-242-1811
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Provider Business Mailing Address
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Address Line | 600 E. RIVERPARK LN., STE. 100
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City | BOISE
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State | ID
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Zip | 83706-7237
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Country | US
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Telephone | 208-258-3600
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Fax | 808-242-1811
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | DT1985
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License Number State | HI
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Taxonomy #2
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | D1818
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License Number State | ID
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