FACIAL ORAL AND DENTAL IMPLANT SURGERY ASSOCIATES INC. NPI 1003060591

NPI Information

FACIAL ORAL AND DENTAL IMPLANT SURGERY ASSOCIATES, INC. is an oral and maxillofacial surgery dentist in Lewiston, ID. The provider is an oral and maxillofacial surgery dentist specialized in the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region. FACIAL ORAL AND DENTAL IMPLANT SURGERY ASSOCIATES, INC. NPI is 1003060591. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Oral And Facial Surgery.

The provider's business location address is:

3326 4TH ST STE 2
LEWISTON, ID
ZIP 83501-455
Phone: (208) 743-1640
Fax: (208) 743-1643

The provider's authorized official is Stephen Wilford Holm .
The authorized official title is Owner and has the following contact phone number (208) 743-1640.

The enumeration date for this NPI number is 11/10/2008 and was last updated on 4/14/2011.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

Other Identifiers

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