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Individual

TYE PADILLA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DMD

Contact information

Practice address
223 W IRONWOOD DR, COEUR D ALENE, ID 83814-2651
(208) 277-9321
Mailing address
15720 E 4TH AVE APT C108, SPOKANE VALLEY, WA 99037-8914

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D-5288
ID

Other

Enumeration date
06/11/2021
Last updated
06/12/2021
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