| Davidson Family Dental | |
|
509 W Hanley Ave Ste 201 Coeur D Alene ID 83815-8994 | |
| (208) 667-5447 | |
| (208) 666-8918 |
| Full Name | Davidson Family Dental |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 509 W Hanley Ave Ste 201, Coeur D Alene, Idaho |
| Authorized Official Name and Position | Kirk Michael Davidson (OWNER) |
| Authorized Official Contact | 2086675447 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Davidson Family Dental 509 W Hanley Ave Ste 201 Coeur D Alene ID 83815-8994 Ph: (208) 667-5447 | Davidson Family Dental 509 W Hanley Ave Ste 201 Coeur D Alene ID 83815-8994 Ph: (208) 667-5447 |
| NPI Number | 1922404987 |
|---|---|
| Provider Enumeration Date | 11/18/2014 |
| Last Update Date | 11/18/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1922404987 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | D4322 (Idaho) | Primary |
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