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Southway Orthodontics Pllc
Customized Equipment (DME) in Lewiston, Idaho
NPI 1225577224

Southway Orthodontics Pllc is a Customized Equipment (DME) based in Lewiston, ID and is specialized in Customized Equipment. Southway Orthodontics Pllc practices in Lewiston, ID. The NPI Number for Southway Orthodontics Pllc is 1225577224 and holds a License No. D 3069 OR (Idaho).

The current practice location address for Southway Orthodontics Pllc is 77 Southway Ave, Lewiston, ID and can be reached out via phone at 208-798-4427 and via fax at 208-743-4807.

Location: 77 Southway Ave, Lewiston, ID, 83501-2203
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1225577224
Provider Name
Southway Orthodontics Pllc
Credential
Provider Entity Type
Organization
Address
77 Southway Ave, Lewiston, ID, 83501-2203
Phone Number
208-798-4427
Fax Number
208-743-4807
Provider Enumeration Date
02/23/2017
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
77 Southway Ave
City
Lewiston
State
Idaho
Zip
83501-2203
Phone Number
208-798-4427
Fax Number
208-743-4807
person
Provider Business Mailing Address Details
Address
77 Southway Ave
City
Lewiston
State
Idaho
Zip
83501-2203
Phone Number
208-798-4427
Fax Number
208-743-4807
person
Provider's Taxonomy Details 1
Type
Suppliers
Classification
Durable Medical Equipment & Medical Supplies
Speciality
Customized Equipment
Taxonomy
332BC3200X
License No.
D 3069 OR (Idaho)
Definition
Definition to come...
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