Individual
DR. BENJAMIN LUKE BYRD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
302 E CAMERON AVE, KELLOGG, ID 83837-2333
(208) 786-7031
Mailing address
302 E CAMERON AVE, KELLOGG, ID 83837-2333
(208) 786-7031
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D-4696
ID
Other
Enumeration date
07/31/2013
Last updated
10/14/2015
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