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Organization
KOOTENAI DENTAL GROUP, LLC
Active
Organization
KOOTENAI DENTAL GROUP, LLC
Active
Other names
DeLwyn Lee Dick, D.D.S.
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DELWYN LEE DICK DDS (CEO)
(208) 762-8750
Entity
Organization
Contact information
Practice address
555 W. CANFIELD AVENUE, COEUR D'ALENE, ID 83815-7892
(208) 762-8750
(208) 762-2530
Mailing address
555 W. CANFIELD AVENUE, COEUR D'ALENE, ID 83815-7892
(208) 762-8750
(208) 762-2530
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
ID03049
ID
Other
Enumeration date
09/22/2006
Last updated
08/22/2020
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