Organization
PALOUSE PEDIATRIC DENTISTRY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KAREN M SEPT D.M.D. (OWNER)
(208) 882-9999
Entity
Organization
Contact information
Practice address
1246 W A ST, MOSCOW, ID 83843-2277
(208) 882-9999
(208) 882-9998
Mailing address
1246 W A ST, MOSCOW, ID 83843-2277
(208) 882-9999
(208) 882-9998
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
D-4108-PD
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
807993200
—
ID
Enumeration date
05/30/2008
Last updated
05/30/2008
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