| Cda Kids Dentistry Pllc | |
|
1341 N Northwood Center Ct Ste B Coeur D Alene ID 83814-2471 | |
| (208) 500-2204 | |
| (208) 619-4619 |
| Full Name | Cda Kids Dentistry Pllc |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 1341 N Northwood Center Ct Ste B, Coeur D Alene, Idaho |
| Authorized Official Name and Position | Devin Morin (MANAGING MEMBER/SOLE MEMBER) |
| Authorized Official Contact | 5027129561 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Cda Kids Dentistry Pllc 1110 E Silver Pine Rd Colbert WA 99005-5125 Ph: () - | Cda Kids Dentistry Pllc 1341 N Northwood Center Ct Ste B Coeur D Alene ID 83814-2471 Ph: (208) 500-2204 |
| NPI Number | 1689346736 |
|---|---|
| Provider Enumeration Date | 09/28/2021 |
| Last Update Date | 09/28/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1689346736 | NPI | - | NPPES |
| 2138247 | Medicaid | WA | |
| 44756 | Medicaid | ID |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
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