| Palouse Pediatric Dentistry | |
|
1246 W A St Moscow ID 83843-2277 | |
| (208) 882-9999 | |
| (208) 882-9998 |
| Full Name | Palouse Pediatric Dentistry |
|---|---|
| Speciality | Dentist - Pediatric Dentistry |
| Location | 1246 W A St, Moscow, Idaho |
| Authorized Official Name and Position | Karen M Sept (OWNER) |
| Authorized Official Contact | 2088829999 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Palouse Pediatric Dentistry 1246 W A St Moscow ID 83843-2277 Ph: (208) 882-9999 | Palouse Pediatric Dentistry 1246 W A St Moscow ID 83843-2277 Ph: (208) 882-9999 |
| NPI Number | 1013175595 |
|---|---|
| Provider Enumeration Date | 05/30/2008 |
| Last Update Date | 05/30/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1013175595 | NPI | - | NPPES |
| 807993200 | Medicaid | ID |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0221X | Dentist - Pediatric Dentistry | D-4108-PD (Idaho) | Primary |
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