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939 Bryden Ave Lewiston ID 83501-5057 | |
| (208) 746-2668 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Dentist |
| Location | 939 Bryden Ave, Lewiston, Idaho |
| Authorized Official Name and Position | Randy Lee Sorensen (PRESIDENT) |
| Authorized Official Contact | 2087462668 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
939 Bryden Ave Lewiston ID 83501-5057 Ph: (208) 746-2668 | 939 Bryden Ave Lewiston ID 83501-5057 Ph: (208) 746-2668 |
| NPI Number | 1932119161 |
|---|---|
| Provider Enumeration Date | 08/09/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1932119161 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | D3092 (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 |