Organization
COEUR D ALENE FAMILY DENTISRTY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. TYLER SCOFIELD MORTON (CONSULTANT)
(208) 626-2625
Entity
Organization
Contact information
Practice address
2201 N GOVERNMENT WAY, SUITE G, COEUR D ALENE, ID 83814-3658
(208) 664-9129
(208) 664-9120
Mailing address
2201 N GOVERNMENT WAY, SUITE G, COEUR D ALENE, ID 83814-3658
(208) 664-9129
(208) 664-9120
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
D4087
ID
Other
Enumeration date
04/23/2014
Last updated
04/23/2014
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