Organization
LAROSE DENTAL PA
Active
Other names
Kootenai Family Dental
Organization subpart
No
Provider details
NPI number
Authorized official
ALEXIS LAROSE DDS (PRESIDENT/DENTIST)
(208) 664-8283
Entity
Organization
Contact information
Practice address
1420 LINCOLN WAY, SUITE 200, COEUR D ALENE, ID 83814-2390
(208) 664-8283
Mailing address
1420 LINCOLN WAY, SUITE 200, COEUR D ALENE, ID 83814-2390
(208) 664-8283
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
D4454
ID
Other
Enumeration date
10/08/2012
Last updated
10/08/2012
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