Organization
CHANNING WAY DENTAL DBA LOST RIVERS DENTAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. COREY CHRISTENSE D.D.S. (PARTNER)
(208) 527-3472
Entity
Organization
Contact information
Practice address
520 HIGHLAND DRIVE, ARCO, ID 83213
(208) 527-3472
(208) 527-8955
Mailing address
PO BOX 5, ARCO, ID 83213-0005
(208) 527-3472
(208) 527-8955
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D3703
ID
Other
Enumeration date
04/06/2007
Last updated
03/25/2008
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