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Individual

DR. LON NORMAN PECKHAM

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DMD

Contact information

Practice address
801 E MEDICAL CT, POST FALLS, ID 83854-7298
(855) 553-7566
Mailing address
351 MOOSE MEADOW DR, PRIEST RIVER, ID 83856-9265
(855) 553-7566

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
60576227
WA
122300000X
Dentist
Primary
D1901
ID

Other

Enumeration date
06/27/2007
Last updated
08/19/2015
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