| Lakeview Dental | |
|
801 W Milwaukee Dr Coeur D Alene ID 83814-2236 | |
| (208) 664-0884 | |
| (208) 664-3304 |
| Full Name | Lakeview Dental |
|---|---|
| Speciality | Dentist |
| Location | 801 W Milwaukee Dr, Coeur D Alene, Idaho |
| Authorized Official Name and Position | Spencer Wirig (OWNER) |
| Authorized Official Contact | 2086640884 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Lakeview Dental 801 W Milwaukee Dr Coeur D'alene ID 83814 Ph: () - | Lakeview Dental 801 W Milwaukee Dr Coeur D Alene ID 83814-2236 Ph: (208) 664-0884 |
| NPI Number | 1801241922 |
|---|---|
| Provider Enumeration Date | 04/26/2016 |
| Last Update Date | 04/26/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1801241922 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | D4020 (Idaho) | Primary |
| 332BC3200X | Durable Medical Equipment & Medical Supplies - Customized Equipment | D4020 (Idaho) | Secondary |
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