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General NPI Number Information
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NPI Number | 1982592598
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Entity Type | Organization
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Legal Business Name | STEVEN GIGLI DDS, PLLC
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Dates
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Enumeration Date | 06/24/2025
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Last Update Date | 06/24/2025
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Provider Practice Location Address
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Address Line | 450 W AIRBASE RD
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City | MOUNTAIN HOME
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State | ID
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Zip | 83647-3483
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Country | US
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Telephone | 208-587-1111
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Fax |
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Provider Business Mailing Address
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Address Line | 5943 S RISING SUN WAY
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City | BOISE
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State | ID
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Zip | 83709-6577
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER/DENTIST
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Name | STEVEN GIGLI
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Credential | DDS
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Telephone | 209-662-2723
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number |
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License Number State |
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