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Organization

IDAHO FAMILY DENTAL CENTER, PLLC

Active
Other names
Davidson Family Dental
Organization subpart
No

Provider details

NPI number
Authorized official
DR. MATTHEW DAVID NORDLIE DMD (OWNER/DENTIST)
(253) 249-3581
Entity
Organization

Contact information

Practice address
509 W HANLEY AVE STE 201, COEUR D ALENE, ID 83815-8994
(208) 667-5447
Mailing address
509 W HANLEY AVE STE 201, COEUR D ALENE, ID 83815-8994
(208) 667-5447

Taxonomy

Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary

Other

Enumeration date
08/10/2022
Last updated
08/10/2022
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