| Mcnamara Family Dentistry | |
|
13997 W Highway 53 Rathdrum ID 83858-8594 | |
| (208) 687-0688 | |
| (208) 687-0447 |
| Full Name | Mcnamara Family Dentistry |
|---|---|
| Speciality | Dentist |
| Location | 13997 W Highway 53, Rathdrum, Idaho |
| Authorized Official Name and Position | James M Mcnamara (PRESIDENT OF CORPORATION) |
| Authorized Official Contact | 2086870688 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mcnamara Family Dentistry 13997 W Highway 53 Rathdrum ID 83858 Ph: (208) 687-0688 | Mcnamara Family Dentistry 13997 W Highway 53 Rathdrum ID 83858-8594 Ph: (208) 687-0688 |
| NPI Number | 1245433143 |
|---|---|
| Provider Enumeration Date | 06/07/2007 |
| Last Update Date | 06/21/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1245433143 | NPI | - | NPPES |
| 000154200 | Medicaid | ID |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | D1605 (Idaho) | Primary |
Lakeland Family Dental Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 14596 Id-41, Rathdrum, ID 83858 Phone: 208-687-4455 | |
Lakeland Family Dental Llc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 14596 N Highway 41, Rathdrum, ID 83858 Phone: 208-687-4455 Fax: 208-687-4456 |