Kootenai Family Dental, Pa | |
1420 Lincoln Way Suite 200 Coeur Dalene ID 83814 | |
(208) 664-8283 | |
(208) 667-0794 |
Full Name | Kootenai Family Dental, Pa |
---|---|
Speciality | Dentist |
Location | 1420 Lincoln Way, Coeur Dalene, Idaho |
Authorized Official Name and Position | Robert L Wilder (DENTIST) |
Authorized Official Contact | 2086648283 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Kootenai Family Dental, Pa 1420 Lincoln Way Suite 200 Coeur Dalene ID 83814 Ph: (208) 664-8283 | Kootenai Family Dental, Pa 1420 Lincoln Way Suite 200 Coeur Dalene ID 83814 Ph: (208) 664-8283 |
NPI Number | 1942317664 |
---|---|
Provider Enumeration Date | 08/25/2006 |
Last Update Date | 10/06/2008 |
Identifier | Type | State | Issuer |
---|---|---|---|
1942317664 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
122300000X | Dentist | 3794 (Idaho) | Primary |