Organization
TYLER SHOEMAKER DMD PC
Active
Other names
Priest River Dental
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TYLER SHOEMAKER DMD (CEO)
(208) 448-2694
Entity
Organization
Contact information
Practice address
314 E ALBENI HWY, SUITE 101, PRIEST RIVER, ID 83856-9207
(208) 448-2694
(208) 448-1703
Mailing address
314 E ALBENI HWY, SUITE 101, PRIEST RIVER, ID 83856-9207
(208) 448-2694
(208) 448-1703
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D4128
ID
Other
Enumeration date
04/25/2008
Last updated
04/25/2008
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