Individual
RONALD W FORSBERG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS PA
Contact information
Practice address
2005 PINE ST, SANDPOINT, ID 83864-9327
(208) 265-4115
(208) 265-2365
Mailing address
2005 PINE ST, SANDPOINT, ID 83864-9327
(208) 265-4115
(208) 265-2365
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D1746
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000010009601
REGENCE BLUE SHIELD OF ID
ID
05
—
000439700
—
ID
01
—
67413
BLUE CROSS OF IDAHO
ID
Enumeration date
09/20/2006
Last updated
08/06/2009
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