| North Idaho Dental Group | |
|
2165 N Merritt Creek Coeur D Alene ID 83814-8381 | |
| (208) 667-8282 | |
| Not Available |
| Full Name | North Idaho Dental Group |
|---|---|
| Speciality | Dentist |
| Location | 2165 N Merritt Creek, Coeur D Alene, Idaho |
| Authorized Official Name and Position | Amy Winter (OFFICE MANAGER) |
| Authorized Official Contact | 2086678282 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| North Idaho Dental Group 2165 N Merritt Creek Loop Coeur D Alene ID 83814-4949 Ph: (208) 667-8282 | North Idaho Dental Group 2165 N Merritt Creek Coeur D Alene ID 83814-8381 Ph: (208) 667-8282 |
| NPI Number | 1811537251 |
|---|---|
| Provider Enumeration Date | 01/14/2020 |
| Last Update Date | 02/03/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1811537251 | NPI | - | NPPES |
| 1184035115 | Other | CHACE MICKELSON |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | (* (Not Available)) | Primary |
| 1223D0001X | Dentist - Dental Public Health | (* (Not Available)) | Secondary |
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