# SPENCER C WIRIG, DMD, INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Lakeview Dental Clinic
- **Organization subpart:** No

## Provider details

- **NPI number:** 1356654172
- **Authorized official:** DR. SPENCER C WIRIG DMD (PRESIDENT)
- **Authorized official phone:** (208) 664-0884

## Contact information

- **Practice address:** 801 W MILWAUKEE DR, COEUR D ALENE, ID 83814-2236
- **Practice address phone:** (208) 664-0884
- **Practice address fax:** (208) 664-3304
- **Mailing address:** 801 W MILWAUKEE DR, COEUR D ALENE, ID 83814-2236
- **Mailing address phone:** (208) 664-0884
- **Mailing address fax:** (208) 664-3304

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | D4020 | ID | Yes |

## Other

- **Enumeration date:** 07/21/2010
- **Last updated:** 07/21/2010