Individual
MR. BRET BOYLE CHRISTENSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS MS
Contact information
Practice address
77 SOUTHWAY AVE, STE D, LEWISTON, ID 83501-2200
(208) 798-4427
(208) 743-4807
Mailing address
77 SOUTHWAY AVE, STE D, LEWISTON, ID 83501-2200
(208) 798-4427
(208) 743-4807
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
D3069OR
ID
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
D3069OR
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000010033124
REGENCE BLUE SHIELD OF ID
ID
Enumeration date
09/16/2006
Last updated
09/11/2025
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