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MATTHEW TUFT DENTAL LLC NPI 1417285354


NPI Information

NPI: 1417285354
Provider Name: MATTHEW TUFT DENTAL LLC

Doing Business As: COPPERSTONE DENTAL

Classification: Dentist - 1223G0001X
Entity Type: Organization

Specialization: General Practice

Address:
12426 W EXPLORER DR
STE 210
BOISE, ID
ZIP 83713
Phone: (208) 376-5499
Get Directions

MATTHEW TUFT DENTAL LLC is a general practice dentist in Boise, ID. The provider is a general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. MATTHEW TUFT DENTAL LLC NPI is 1417285354. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Copperstone Dental.

The provider's business location address is:

12426 W EXPLORER DR
STE 210
BOISE, ID
ZIP 83713-572
Phone: (208) 376-5499
Fax: (208) 376-5527

The provider's authorized official is Linda Sterling .
The authorized official title is Office Manager and has the following contact phone number (208) 376-5499.

The enumeration date for this NPI number is 12/4/2009 and was last updated on 12/4/2009.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
11223G0001XDentistGeneral PracticeD4053IDAHOYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1807788800MEDICAIDIDAHO

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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