Organization
DENTURE SERVICE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AARON DICKINSON (OWNER)
(208) 743-2881
Entity
Organization
Contact information
Practice address
330 5TH ST, LEWISTON, ID 83501-2408
(208) 743-2881
Mailing address
330 5TH ST, LEWISTON, ID 83501-2408
Taxonomy
Speciality
Code
Description
License number
State
122400000X
Denturist
Primary
LD-33
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5020318
—
WA
Enumeration date
04/19/2010
Last updated
04/19/2010
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