Organization
CDA KIDS DENTISTRY PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DEVIN MORIN DMD (MANAGING MEMBER/SOLE MEMBER)
(502) 712-9561
Entity
Organization
Contact information
Practice address
1341 N NORTHWOOD CENTER CT STE B, COEUR D ALENE, ID 83814-2471
(208) 500-2204
(208) 619-4619
Mailing address
1110 E SILVER PINE RD, COLBERT, WA 99005-5125
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2138247
—
WA
05
—
44756
—
ID
Enumeration date
09/28/2021
Last updated
09/28/2021
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