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Organization
RANDY L. SORENSEN DMD PA
Active
Organization
RANDY L. SORENSEN DMD PA
Active
Other names
Family Dental Care
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RANDY LEE SORENSEN DMD (PRESIDENT)
(208) 746-2668
Entity
Organization
Contact information
Practice address
939 BRYDEN AVE, LEWISTON, ID 83501-5057
(208) 746-2668
Mailing address
939 BRYDEN AVE, LEWISTON, ID 83501-5057
(208) 746-2668
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
D3092
ID
Other
Enumeration date
08/09/2006
Last updated
08/22/2020
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