| Dentistry '4' Children Pllc | |
|
3326 4th St Suite 4 Lewiston ID 83501-4455 | |
| (208) 743-2505 | |
| (208) 746-6395 |
| Full Name | Dentistry '4' Children Pllc |
|---|---|
| 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 |
|---|---|
| Dentistry '4' Children Pllc 3326 4th St Suite 4 Lewiston ID 83501-4455 Ph: (208) 743-2505 | Dentistry '4' Children Pllc 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 |
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