Individual
BRENT UNRUH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1717 LINCOLN WAY, SUITE 107, COEUR D ALENE, ID 83814-2556
(208) 664-0489
(208) 769-7339
Mailing address
1717 LINCOLN WAY, SUITE 107, COEUR D ALENE, ID 83814-2556
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
D-1764
ID
Other
Enumeration date
04/20/2007
Last updated
07/08/2007
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