NPI 1124037924

Randy Lee Sorensen, DMD

Practitioner Dentist Lewiston, ID

Practice location

Address: 939 Bryden Ave, Lewiston, ID 83501-5057
Phone: (208) 746-2668

Registered specialties

Dentist Primary

Dental Providers Taxonomy 122300000X Licence D3092 (ID)

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Registry record

NPI: 1124037924
Entity type: Individual
Sex (as registered): Male
NPI issued: 8 Aug 2006
Record last updated: 8 Jul 2007

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.