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Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

DR. DEWAYNE LAVERNE BRISCOE, DDS MD

Active Sole Proprietor

DR. DEWAYNE LAVERNE BRISCOE, DDS MD is a Oral & Maxillofacial Surgery healthcare provider located in SUN VALLEY, Idaho. NPI 1003242769 is currently active in the NPPES registry. Verify at CMS.

Oral & Maxillofacial Surgery · SUN VALLEY, ID

Registration Details

NPI Number
1003242769
Provider Type
Individual
Gender
Male
NPI Issued
Sep 25, 2013 (12.844944330484 yrs)
Last Updated
Sep 25, 2013
License
D-1661-OS (ID)
Sole Proprietor
Yes

Practice Information

Address
404 FAIRWAY LOOP
SUN VALLEY, ID, 83353
Browse ID providers · Browse ZIP 83353
Phone
2087209546
Primary Specialty
Oral & Maxillofacial Surgery
1223S0112X
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.