| Lakeview Dental | |
|
801 W Milwaukee Dr Coeur D Alene ID 83814-2236 | |
| (208) 664-0884 | |
| Not Available |
| Full Name | Lakeview Dental |
|---|---|
| Speciality | Dentist - Prosthodontics |
| Location | 801 W Milwaukee Dr, Coeur D Alene, Idaho |
| Authorized Official Name and Position | Alvin Brett Matteson (OWNER/ PROSTHODONTIST) |
| Authorized Official Contact | 2708532508 |
| 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 83814-2236 Ph: (208) 664-0884 | Lakeview Dental 801 W Milwaukee Dr Coeur D Alene ID 83814-2236 Ph: (208) 664-0884 |
| NPI Number | 1679096523 |
|---|---|
| Provider Enumeration Date | 07/24/2017 |
| Last Update Date | 07/21/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1679096523 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | D-4027 (Idaho) | Secondary |
| 1223P0700X | Dentist - Prosthodontics | D-4027 (Idaho) | Primary |
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