Individual
BRIAN L. WARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
857 POLK ST, TWIN FALLS, ID 83301-3985
(208) 734-4314
Mailing address
857 POLK ST, TWIN FALLS, ID 83301-3985
(208) 734-4314
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
D-4030-OR
ID
Other
Enumeration date
01/31/2007
Last updated
07/08/2007
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