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Organization
HEARTWOOD FAMILY DENTAL, PC
Active
Organization
HEARTWOOD FAMILY DENTAL, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LOGAN F HAZARD DMD (PRESIDENT)
(208) 215-1426
Entity
Organization
Contact information
Practice address
102 W 11TH AVE, SUITE C, POST FALLS, ID 83854-9255
(208) 777-1542
(208) 773-1490
Mailing address
102 W 11TH AVE, SUITE C, POST FALLS, ID 83854-9255
(208) 777-1542
(208) 773-1490
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D-4401
ID
Other
Enumeration date
11/28/2012
Last updated
11/28/2012
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