Individual
DR. LAWRENCE JOHN CHILD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS, PC
Contact information
Practice address
126 5TH AVE W, GOODING, ID 83330-1202
(208) 934-4610
(208) 934-0901
Mailing address
126 5TH AVE W, GOODING, ID 83330-1202
(208) 934-4610
(208) 934-0901
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D1473
ID
Other
Enumeration date
09/02/2006
Last updated
07/08/2007
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