IndividualActive
Dewayne Briscoe, DDS MD
NPI 1003242769 · Oral and Maxillofacial Surgery (Dentist) · Sun Valley, ID
Provider details
- NPI number
- 1003242769
- Entity type
- Individual
- Primary specialty
- Oral and Maxillofacial Surgery (Dentist)Dental Providers
- Credential
- DDS MD
- Sex
- Male
- Sole proprietor
- Yes
- License
- D-1661-OS (ID)
Specialties & taxonomies
Dental Providers
Practice location
404 Fairway Loop
Sun Valley, ID 83353
Phone: (208) 720-9546
Approximate (ZIP-level) locationGet directions
Mailing address
Po Box 147
Sun Valley, ID 83353-0147
Registry dates
- Enumerated
- 2013-09-25
- Last updated
- 2013-09-25
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.