# LASER DENTISTRY OF COEUR D'ALENE

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1326393786
- **Authorized official:** KENT E MOSLEY D.D.S. (OWNER)
- **Authorized official phone:** (208) 667-1154

## Contact information

- **Practice address:** 910 W. IRONWOOD DR., COEUR D'ALENE, ID 83814
- **Practice address phone:** (208) 667-1154
- **Practice address fax:** (208) 667-9024
- **Mailing address:** 910 W. IRONWOOD DR., COEUR D'ALENE, ID 83814
- **Mailing address phone:** (208) 667-1154
- **Mailing address fax:** (208) 667-9024

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | — | — | Yes |

## Other

- **Enumeration date:** 07/20/2012
- **Last updated:** 07/20/2012

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 80685000 | — | ID |