Dr. Lawrence John Child, DDS, PC
Dentist, General Practice in Gooding, ID. Individual provider (NPI-1).
NPI number1811099765
StatusActive
Last updated in NPPESJul 8, 2007
Details
- NPI
- 1811099765
- Entity type
- Individual (NPI-1)
- Name
- Dr. Lawrence John Child
- Credential
- DDS, PC
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Sep 2, 2006
- Last updated
- Jul 8, 2007
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1223G0001X | Dentist, General Practice | d1473 | ID | Yes |
Practice location
126 5th Ave WGooding, ID 83330-1202
Phone 208-934-4610 · Fax 208-934-0901
Mailing address
126 5th Ave WGooding, ID 83330-1202
Phone 208-934-4610 · Fax 208-934-0901
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