NPI 1003060591

Facial Oral and Dental Implant Surgery Associates, INC.

Organisation Oral and Maxillofacial Surgery (Dentist) Lewiston, ID

Practice location

Address: 3326 4th St STE 2, Lewiston, ID 83501-4455
Phone: (208) 743-1640
Fax: (208) 743-1643

Authorised official

Name: Stephen Wilford Holm
Title: Owner
Phone: (208) 743-1640

Registered specialties

Oral and Maxillofacial Surgery (Dentist) Primary

Dental Providers Taxonomy 1223S0112X Licence D-4057 (ID)

Other Dentist providers in Idaho →

Registry record

NPI: 1003060591
Entity type: Organization
NPI issued: 10 Nov 2008
Record last updated: 14 Apr 2011

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.