Individual
KEVEN FREEMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
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
(208) 454-0473
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D-4834
ID
Other
Enumeration date
07/02/2015
Last updated
07/21/2022
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