Southway Orthodontics Pllc

NPI #1225577224 in Lewiston, Idaho

Provider Information

NPI Number: 1225577224
Entity Type: Organization
Organization Name: Southway Orthodontics Pllc
Primary Specialty: Durable Medical Equipment & Medical Supplies - Customized Equipment
Enumeration Date: Feb 23, 2017
Last Updated: Feb 23, 2017

Practice Location

Address: 77 SOUTHWAY AVE
Address 2: SUITE D
City: Lewiston
State: Idaho
ZIP Code: 83501-2203
Phone: (208) 798-4427

Authorized Official

Name: DR. BRET CHRISTENSEN, DDS, MS
Title: DR
Phone: (208) 791-0428

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Durable Medical Equipment & Medical Supplies - Customized Equipment — Customized Equipment	332BC3200X	Primary

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