Randy L. Sorensen Dmd PA

NPI #1932119161 in Lewiston, Idaho

Provider Information

NPI Number: 1932119161
Entity Type: Organization
Organization Name: Randy L. Sorensen Dmd PA
Primary Specialty: Dentist
Enumeration Date: Aug 9, 2006
Last Updated: Aug 22, 2020

Practice Location

Address: 939 BRYDEN AVE
City: Lewiston
State: Idaho
ZIP Code: 83501-5057
Phone: (208) 746-2668

Authorized Official

Name: DR. RANDY LEE SORENSEN, DMD
Title: PRESIDENT
Phone: (208) 746-2668

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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