Channing Way Dental DBA Lost Rivers Dental

NPI #1588786875 in Arco, Idaho

Provider Information

NPI Number: 1588786875
Entity Type: Organization
Organization Name: Channing Way Dental DBA Lost Rivers Dental
Primary Specialty: Dentist - General Practice
Enumeration Date: Apr 6, 2007
Last Updated: Mar 25, 2008

Practice Location

Address: 520 HIGHLAND DRIVE
City: Arco
State: Idaho
ZIP Code: 83213
Phone: (208) 527-3472

Authorized Official

Name: DR. COREY CHRISTENSE, D.D.S.
Title: PARTNER
Phone: (208) 527-3472

Specialties & Taxonomy Codes

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

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