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Organization

ID OMS SPECIALTY DENTAL SERVICES, PLLC

Active
Other names
Specialty Dental Brands
Organization subpart
No

Provider details

NPI number
Authorized official
CHARLOTTE DASCH (DIRECTOR OF PROVIDER RELATIONS)
(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
401 CHURCH ST STE 1400, NASHVILLE, TN 37219-2214
(504) 638-0303

Taxonomy

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

Other

Enumeration date
08/30/2021
Last updated
08/30/2021
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