Individual
DR. CODY KENT HAAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
1639 23RD AVE, LEWISTON, ID 83501-6308
(208) 746-0431
Mailing address
1639 23RD AVE, LEWISTON, ID 83501-6308
(208) 746-0431
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
D-4156
ID
1223P0700X
Prosthodontics
DE 60023524
WA
Other
Enumeration date
10/02/2009
Last updated
10/02/2009
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