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1679098008
JOSHUA LEWIS
IDAHO FALLS, ID
NPI
1679098008
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
122300000X Dentist
(Licence: ID 5167)
Additional Taxonomies
122300000X Dentist
(Licence: MO 2017028241)
Enumeration Date
2017-08-07
Last Update Date
2024-08-09
Business Address
JOSHUA LEWIS
675 S WOODRUFF AVE
IDAHO FALLS, ID 83401-5596
Phone number: 208-538-0104
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Mailing Address
JOSHUA LEWIS
242 E MAIN ST
REXBURG, ID 83440-2022
Phone number: 208-932-4250
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