Organization
KEVEN FREEMAN DMD PLLC
Active
Other names
Crystal Canyon Family Dental
Organization subpart
No
Provider details
NPI number
Authorized official
KEVEN FREEMAN DMD (OWNER)
(801) 520-6325
Entity
Organization
Contact information
Practice address
616 S 10TH AVE, CALDWELL, ID 83605-4112
(208) 454-0473
Mailing address
616 S 10TH AVE, CALDWELL, ID 83605-4112
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
D-4834
ID
Other
Enumeration date
05/30/2017
Last updated
05/30/2017
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