Individual
GALEN KENT HAAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
1639 23RD AVE, LEWISTON, ID 83501-6308
(208) 746-0431
(208) 746-2766
Mailing address
1639 23RD AVE, LEWISTON, ID 83501-6308
(208) 746-0431
(208) 746-2766
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
66D1553
ID
Other
Enumeration date
11/08/2012
Last updated
11/08/2012
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