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General NPI Number Information
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NPI Number | 1992976765
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Entity Type | Organization
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Legal Business Name | DARON STEVENS ORTHODONTICS
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Dates
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Enumeration Date | 03/19/2008
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Last Update Date | 03/19/2008
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Provider Practice Location Address
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Address Line | 119 S VALLEY DR SUITE E
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City | NAMPA
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State | ID
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Zip | 83686-2974
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Country | US
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Telephone | 208-468-9191
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Fax | 208-466-7479
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Provider Business Mailing Address
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Address Line | 119 S VALLEY DR SUITE E
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City | NAMPA
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State | ID
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Zip | 83686-2974
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Country | US
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Telephone | 208-468-9191
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Fax | 208-466-7479
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Authorized Official
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Title or Position | ORTHODONTIST
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Name | DR. DARON R. STEVENS
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Credential | DDS
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Telephone | 208-468-9191
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | D3738-OR
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License Number State | ID
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