Organization
LAKELAND FAMILY DENTAL LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KYRA LUCK (OFFICE MANAGER)
(208) 687-4455
Entity
Organization
Contact information
Practice address
14596 N HIGHWAY 41, RATHDRUM, ID 83858-8682
(208) 687-4455
(208) 687-4456
Mailing address
PO BOX 1030, RATHDRUM, ID 83858-1030
(208) 687-4455
(208) 687-4456
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
10/02/2025
Last updated
10/02/2025
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