Organization
LASER DENTISTRY OF COEUR D'ALENE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KENT E MOSLEY D.D.S. (OWNER)
(208) 667-1154
Entity
Organization
Contact information
Practice address
910 W. IRONWOOD DR., COEUR D'ALENE, ID 83814
(208) 667-1154
(208) 667-9024
Mailing address
910 W. IRONWOOD DR., COEUR D'ALENE, ID 83814
(208) 667-1154
(208) 667-9024
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
80685000
—
ID
Enumeration date
07/20/2012
Last updated
07/20/2012
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