Individual
MR. AARON KENT DICKINSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LD
Contact information
Practice address
330 5TH STREET, LEWISTON, ID 83501
(208) 743-2881
(208) 743-0719
Mailing address
330 5TH STREET, LEWISTON, ID 83501
(208) 743-2881
(208) 743-0719
Taxonomy
Speciality
Code
Description
License number
State
122400000X
Denturist
Primary
LD33
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
002560200
—
ID
Enumeration date
12/11/2006
Last updated
04/15/2010
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