Individual
CHAD EVAN SELLERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
607 2ND ST S, NAMPA, ID 83651-3837
(208) 466-2456
Mailing address
1881 W DIVIDE CREEK ST, MERIDIAN, ID 83646-3464
(208) 515-1466
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D-5158
ID
Other
Enumeration date
06/17/2020
Last updated
06/17/2020
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