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105 E 10th Ave Post Falls ID 83854-5125 | |
| (208) 773-8388 | |
| (208) 777-0346 |
| Full Name | |
|---|---|
| Speciality | Dentist |
| Location | 105 E 10th Ave, Post Falls, Idaho |
| Authorized Official Name and Position | Rheanna R. Burnham (OWNER) |
| Authorized Official Contact | 2087738388 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
105 E 10th Ave Post Falls ID 83854-5125 Ph: (208) 773-8388 | 105 E 10th Ave Post Falls ID 83854-5125 Ph: (208) 773-8388 |
| NPI Number | 1699117440 |
|---|---|
| Provider Enumeration Date | 07/22/2013 |
| Last Update Date | 07/22/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1699117440 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | D4332 (Idaho) | Primary |
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