Individual
KARL DOUGLAS PEACH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS, MS
Contact information
Practice address
1145 E POLSTON AVE., POST FALLS, ID 83854
(208) 777-1010
(208) 773-0667
Mailing address
1145 E. POLSTON AVE., POST FALLS, ID 83854
(208) 777-1010
(208) 773-0667
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
37273
CA
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
DE00007291
WA
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
N-05306
ID
Other
Enumeration date
12/22/2010
Last updated
12/22/2010
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