Organization
RANDY L. SORENSEN DMD PA
Active
Other names
Family Dental Care
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RANDY LEE SORENSEN DMD (PRESIDENT)
(208) 746-2668
Entity
Organization
Contact information
Practice address
939 BRYDEN AVE, LEWISTON, ID 83501-5057
(208) 746-2668
Mailing address
939 BRYDEN AVE, LEWISTON, ID 83501-5057
(208) 746-2668
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
D3092
ID
Other
Enumeration date
08/09/2006
Last updated
08/22/2020
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