Individual
DR. KIRK D DAVIDSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
476653 HIGHWAY 95, SUITE 1, PONDERAY, ID 83852-9816
(208) 265-6771
Mailing address
476653 HIGHWAY 95, SUITE 1, PONDERAY, ID 83852-9816
(208) 265-6771
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D-3694
ID
Other
Enumeration date
02/01/2008
Last updated
02/01/2008
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