NPI 1669179495

Nicholas Ryan Gensburger, LD

Practitioner Denturist Caldwell, ID

Practice location

Address: 2124 Blaine St, Caldwell, ID 83605-4426
Phone: (208) 454-0311

Registered specialties

Denturist Primary

Dental Providers Taxonomy 122400000X Licence LD-136 (ID)

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Registry record

NPI: 1669179495
Entity type: Individual
Sex (as registered): Male
NPI issued: 13 Feb 2023
Record last updated: 13 Feb 2023

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.