Coeur D Alene Family Dentisrty

NPI 1144640509 - Dentist - 122300000X

NPI Details
NPI 1144640509
Enumeration Date 04/23/2014
Last Updated 04/23/2014
Entity Type Healthcare Provider
Active Over 2 years ago
Authorized Information
Name TYLER SCOFIELD TYLER
Position CONSULTANT
Phone (208) 664-9129
Fax (208) 664-9120
Practice Location
2201 N GOVERNMENT WAY
SUITE G
COEUR D ALENE ID, 83814-3658, US
Phone (208) 664-9129
Fax (208) 664-9120
Business Location
2201 N GOVERNMENT WAY
SUITE G
COEUR D ALENE ID, 83814-3658, US
Phone (208) 664-9129
Fax (208) 664-9120
Toxanomy
Taxonomy Code 122300000X
License State Idaho
License Number D4087
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According to our database, Coeur D Alene Family Dentisrty NPI is 1144640509, taxonomy code is 122300000X and license number is D4087, license state is located at Idaho. Coeur D Alene Family Dentisrty physically located at 2201 N Government Way, Coeur D Alene ID, 83814-3658. NPI Number 1033115704 has the healthcare provider type.

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1144640509 NPI number is provided on an as is basis without warranty of any kind. 1144640509 is maintained by the National Plan & Provider Enumeration System. The contents of Coeur D Alene Family Dentisrty are for informational purposes only.