Individual
DR. RICHARD JOHN MONTANDON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
1859 N LAKEWOOD DR STE 101, COEUR D ALENE, ID 83814-2661
(208) 818-6527
Mailing address
1859 N LAKEWOOD DR STE 101, COEUR D ALENE, ID 83814-2661
(208) 818-6527
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
DE60688067
WA
1223D0004X
Dental Anesthesiology
DS039119
PA
1223D0004X
Dental Anesthesiology
Primary
GA60690773
WA
Other
Enumeration date
06/29/2009
Last updated
05/25/2021
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