| Family Dental Care | |
|
939 Bryden Ave Lewiston ID 83501-5057 | |
| (208) 746-2668 | |
| Not Available |
| Full Name | Family Dental Care |
|---|---|
| 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 |
|---|---|
| Family Dental Care 939 Bryden Ave Lewiston ID 83501-5057 Ph: (208) 746-2668 | Family Dental Care 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 |
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