Organization
JOHN M UKICH
Active
Parent organization
JOHN M UKICH, DDS, PA
Other names
Pediatric Dental Center of North Idaho
Organization subpart
Yes
Provider details
NPI number
Legal business name
JOHN M UKICH, DDS, PA
Authorized official
JOHN M UKICH (PRESIDENT)
(208) 667-3556
Entity
Organization
Contact information
Practice address
1310 PONDEROSA DR, SUITE B, SANDPOINT, ID 83864-5073
(208) 255-5410
(208) 255-5420
Mailing address
1310 PONDEROSA DR, SUITE B, SANDPOINT, ID 83864-5073
(208) 255-5410
(208) 255-5420
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
D1656
ID
Other
Enumeration date
03/20/2008
Last updated
03/20/2008
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