NPI:
1265532261
Provider Name:
KOOTENAI DENTAL GROUP, LLC
Other Name: DELWYN LEE DICK, D.D.S.
Classification:
Dentist - 1223G0001X
Entity Type:
Organization
Specialization: General Practice
Address:
555 W. CANFIELD AVENUE
COEUR D'ALENE, ID
ZIP 83815
Phone:
(208) 762-8750
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KOOTENAI DENTAL GROUP, LLC is a general practice dentist in Coeur D'alene, ID. The provider is a general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. KOOTENAI DENTAL GROUP, LLC NPI is 1265532261. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Other Name Is Delwyn Lee Dick, D.d.s..
The provider's business location address is:
555 W. CANFIELD AVENUE
COEUR D'ALENE, ID
ZIP 83815-892
Phone: (208) 762-8750
Fax: (208) 762-2530
The provider's authorized official is Delwyn Lee Dick .
The authorized official title is Ceo and has the following contact phone number (208) 762-8750.
The enumeration date for this NPI number is 9/22/2006 and was last updated on 8/22/2020.