Individual
DR. BYRON PAUL SANSOM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
111 BEVER GRADE ROAD, LAPWAI, ID 83540-0367
(208) 843-2271
(208) 621-4995
Mailing address
P.O. BOX 367, LAPWAI, ID 83540
(208) 843-2271
(208) 935-1005
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
D-4392
ID
Other
Enumeration date
01/08/2010
Last updated
01/02/2020
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