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Organization
KEVEN FREEMAN DMD PLLC
Active
Organization
KEVEN FREEMAN DMD PLLC
Active
Other names
Crystal Canyon Family Dental
Organization subpart
No
Provider details
NPI number
Authorized official
KEVEN FREEMAN DMD (OWNER)
(801) 520-6325
Entity
Organization
Contact information
Practice address
616 S 10TH AVE, CALDWELL, ID 83605-4112
(208) 454-0473
Mailing address
616 S 10TH AVE, CALDWELL, ID 83605-4112
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
D-4834
ID
Other
Enumeration date
05/30/2017
Last updated
05/30/2017
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