SHANNON WIDMIER

KIMBERLY, ID
NPI1396842779
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy1223G0001X Dentist, General Practice
(Licence: ID  D3342)
Enumeration Date2006-09-20
Last Update Date2007-07-08
Business Address
Dr. SHANNON WIDMIER D.D. S. P.A.
702 CENTER STREET WEST
KIMBERLY, ID 83341
Phone number: 208-423-6444
Mailing Address
Dr. SHANNON WIDMIER D.D. S. P.A.
PO BOX B
KIMBERLY, ID 83341-0010
Phone number: 208-423-6444
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