|
| |
|
3326 4th St Suite 4 Lewiston ID 83501-4455 | |
| (208) 743-2505 | |
| (208) 746-6395 |
| Full Name | |
|---|---|
| Speciality | Dentist |
| Location | 3326 4th St, Lewiston, Idaho |
| Authorized Official Name and Position | Laurie Lester (OFFICE MANAGER) |
| Authorized Official Contact | 2087432505 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
3326 4th St Suite 4 Lewiston ID 83501-4455 Ph: (208) 743-2505 | 3326 4th St Suite 4 Lewiston ID 83501-4455 Ph: (208) 743-2505 |
| NPI Number | 1902896772 |
|---|---|
| Provider Enumeration Date | 10/24/2005 |
| Last Update Date | 12/02/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1902896772 | NPI | - | NPPES |
| 806496000 | Medicaid | ID | |
| 806332400 | Medicaid | ID |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | D3494 (Idaho) | Primary |
Perio Docs - Lewiston Pllc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 3323 4th St, Lewiston, ID 83501 Phone: 208-743-1114 Fax: 208-743-3029 | |
John J Johnson Dds Pc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 3510 12th St, Suite 600, Lewiston, ID 83501 Phone: 208-798-7955 Fax: 208-798-7957 | |
Kent B. Simmons Dds, Pllc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 3318 4th St, Lewiston, ID 83501 Phone: 208-746-3694 Fax: 208-743-8313 | |
Yes Today Dentistry Lewiston Pllc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 2360 Thain Grade, Lewiston, ID 83501 Phone: 208-717-1966 |