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Contact Information

DEWAYNE L BRISCOE, DDS MD
404 FAIRWAY LOOP
SUN VALLEY, ID83353
 Phone: 208-720-9546
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Oral and Maxillofacial Surgery

1223S0112X 19 Oral Surgery (Dentist only)
Indicates primary specialty

NPI Profile & details for DEWAYNE L BRISCOE · (Male)

NPI # 1003242769
Status Active
Credentials DDS MD
Entity Individual
Enumeration date 09/25/2013
Last updated 09/25/2013 - About 13 years ago
Sole proprietor 1 Yes
Identifiers
  • ID License # D-1661-OS
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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