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Organization
TWO RIVERS FAMILY DENTISTRY
Active
Organization
TWO RIVERS FAMILY DENTISTRY
Active
Other names
Two Rivers Dentistry Family and Cosmetic
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BENJAMIN WAITES DMD (DENTIST)
(208) 746-2668
Entity
Organization
Contact information
Practice address
937 BRYDEN AVE, LEWISTON, ID 83501
(208) 746-2668
(208) 746-7413
Mailing address
937 BRYDEN AVE, LEWISTON, ID 83501
(208) 746-2668
(208) 746-7413
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
04/27/2021
Last updated
04/27/2021
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