Organization
JOHN M UKICH, DDS,PA
Active
Other names
Pediatric Dental Center of North Idaho
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN M UKICH DDS (PRESIDENT)
(208) 667-3556
Entity
Organization
Contact information
Practice address
1717 LINCOLN WAY, SUITE 205, COEUR D ALENE, ID 83814-2556
(208) 667-3556
(208) 066-4681
Mailing address
1717 LINCOLN WAY, SUITE 205, COEUR D ALENE, ID 83814-2556
(208) 667-3556
(208) 066-4681
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
D1656
ID
Other
Enumeration date
03/19/2008
Last updated
03/19/2008
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