| Coeur D Alene Family Dentisrty | |
|
2201 N Government Way Suite G Coeur D Alene ID 83814-3658 | |
| (208) 664-9129 | |
| (208) 664-9120 |
| Full Name | Coeur D Alene Family Dentisrty |
|---|---|
| Speciality | Dentist |
| Location | 2201 N Government Way, Coeur D Alene, Idaho |
| Authorized Official Name and Position | Tyler Scofield Morton (CONSULTANT) |
| Authorized Official Contact | 2086262625 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Coeur D Alene Family Dentisrty 2201 N Government Way Suite G Coeur D Alene ID 83814-3658 Ph: (208) 664-9129 | Coeur D Alene Family Dentisrty 2201 N Government Way Suite G Coeur D Alene ID 83814-3658 Ph: (208) 664-9129 |
| NPI Number | 1144640509 |
|---|---|
| Provider Enumeration Date | 04/23/2014 |
| Last Update Date | 04/23/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1144640509 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | D4087 (Idaho) | Primary |
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