Individual
DR. KURT ALEXANDER PETELLIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
1717 LINCOLN WAY ST. 105, COEUR D ALENE, ID 83814-2556
(208) 765-0397
(208) 664-9043
Mailing address
1717 LINCOLN WAY, COEUR D ALENE, ID 83814-2556
(208) 765-0397
(208) 664-9043
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D-3130
ID
Other
Enumeration date
03/08/2006
Last updated
06/14/2023
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