Dove, Dustin Lee

Dove, Dustin Lee is an individual health care provider with primary practice located at 211 W Main St , Emmett ID 83617-2937. He recently has only one registered license in Speech, Language and Hearing Service Providers / Hearing Instrument Specialist, which is considered as his primary health care specialty. Dove, Dustin Lee can be contacted via phone (208) 369-4307.

Contact Information

Primary practice address
211 W Main St Emmett ID 83617-2937
Phone: (208) 369-4307
Fax: (208) 369-4503
Website:
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Health care specialties

SpecialtyCodeLicense #State
Speech, Language and Hearing Service Providers / Hearing Instrument Specialist 237700000X HA-1961 Idaho

Profile Details

NPI number 1740741909
LBN Legal business name Dove, Dustin Lee
Credentials BC-HIS
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 28th, 2019
Last updated Nov 7th, 2022 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1740741909 NPPES
Oregon Other 10202510 OREGON HEALTH AUTHORITY
Oregon MEDICAID TPIDTP013943 OREGON HEALTH AUTHORITY
Oregon Other HA-1961 OREGON HEALTH AUTHORITY

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