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Individual

NATHAN ERIN LEAVITT

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DDS

Contact information

Practice address
3326 4TH ST STE 1, LEWISTON, ID 83501-4455
(208) 746-2646
(208) 746-2646
Mailing address
3326 4TH ST STE 1, LEWISTON, ID 83501-4455
(208) 746-2646
(208) 746-2646

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
D-4760
ID

Other

Enumeration date
06/21/2016
Last updated
06/21/2016
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