Davidson Family Dental
Dentist, General Practice in Coeur D Alene, ID. Organization (NPI-2).
NPI number1922404987
StatusActive
Last updated in NPPESNov 18, 2014
Details
- NPI
- 1922404987
- Entity type
- Organization (NPI-2)
- Legal business name
- Davidson Family Dental
- Organization subpart
- No
- Enumeration date
- Nov 18, 2014
- Last updated
- Nov 18, 2014
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1223G0001X | Dentist, General Practice | D4322 | ID | Yes |
Practice location
509 W Hanley Ave Ste 201Coeur D Alene, ID 83815-8994
Phone 208-667-5447 · Fax 208-666-8918
Mailing address
509 W Hanley Ave Ste 201Coeur D Alene, ID 83815-8994
Phone 208-667-5447 · Fax 208-666-8918
Authorized official
Kirk Michael Davidson
Owner
2086675447
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