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1437240009
DWAINE ANTHONY TESNOHLIDEK
FRUITLAND, ID
NPI
1437240009
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
208600000X Surgery
(Licence: ID M6508)
Additional Taxonomies
208600000X Surgery
(Licence: OR MD18758)
Enumeration Date
2006-09-27
Last Update Date
2012-09-18
Business Address
DR. DWAINE ANTHONY TESNOHLIDEK MD
1210 NW 16TH ST
FRUITLAND, ID 83619-2202
Phone number: 208-452-8600
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Mailing Address
DR. DWAINE ANTHONY TESNOHLIDEK MD
190 E BANNOCK ST
BOISE, ID 83712-6241
Phone number: 208-381-2222
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