Individual
CARMEN LEE KOEPL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
803 S MAIN ST STE 120, MOSCOW, ID 83843-2695
(208) 848-8300
(208) 882-5587
Mailing address
611 N IRON BRIDGE WAY, SPOKANE, WA 99202-4932
(509) 444-8888
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
DH-3679
ID
124Q00000X
Dental Hygienist
DH60888742
WA
Other
Enumeration date
08/31/2018
Last updated
03/31/2021
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