Kristin L Fenwick, DDS

NPI #1083745681 in Boise, Idaho

Provider Information

NPI Number: 1083745681
Entity Type: Individual
Name: Kristin L Fenwick, DDS
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Dentist - General Practice
Credential: DDS
Enumeration Date: Mar 8, 2007
Last Updated: Nov 16, 2015

Practice Location

Address: 6657 N GLENWOOD ST
Address 2: WATER'S EDGE DENTAL
City: Boise
State: Idaho
ZIP Code: 83714
Phone: (208) 375-0572

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist - General Practice — General Practice	1223G0001X	Primary

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