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Organization

ID OMS SPECIALTY DENTAL SERVICES, PLLC

Active
Parent organization
ID OMS SPECIALTY DENTAL SERVICES, PLLC
Other names
Implants Northwest
Organization subpart
Yes

Provider details

NPI number
Legal business name
ID OMS SPECIALTY DENTAL SERVICES, PLLC
Authorized official
CHARLOTTE DASCH (DIRECTOR OF CREDENTIALING &PR)
(504) 638-0303
Entity
Organization

Contact information

Practice address
1859 N LAKEWOOD DR STE 101, COEUR D ALENE, ID 83814-2661
(208) 667-5565
Mailing address
1610 54TH AVE N STE 205, NASHVILLE, TN 37209-1442
(615) 678-0759

Taxonomy

Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary

Other

Enumeration date
02/26/2024
Last updated
02/26/2024
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