Dr. Dewayne Laverne Briscoe
Oral and Maxillofacial Surgeon
404 Fairway Loop
Sun Valley
, Idaho 83353
Dr. Dewayne Laverne Briscoe
Oral and Maxillofacial Surgeon
404 Fairway Loop
Sun Valley
, Idaho 83353
(208) 720-9546
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About
Features
Specialties
- Oral and Maxillofacial Surgeon
Languages spoken
- English
Location
First Address
- Dr. Dewayne Laverne Briscoe
- Po Box 147
- Sun Valley, ID
- Zip : 83353-0147
- Phone : (208) 720-9546
Second Address
- Dr. Dewayne Laverne Briscoe
- 404 Fairway Loop
- Sun Valley, ID
- Zip : 83353
- Phone : (208) 720-9546
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 1223S0112X | Oral and Maxillofacial Surgeon | D-1661-OS | ID |
National Provider Identifier
| NPI | 1003242769 |
|---|---|
| Provider Name | Dr. Dewayne Laverne Briscoe |
| First Address | Sun Valley, ID 83353-0147 |
| Second Address | Sun Valley, ID 83353 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | Yes |
| Is Organization Subpart | N/A |
| Enumeration Date | 25/09/2013 |
| Last Update Date | 25/09/2013 |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.