Organization
BRENT R. UNRUH, DMD, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRENT UNRUH (PRESIDENT)
(208) 664-0489
Entity
Organization
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
(208) 664-0489
(208) 769-7339
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
D-1764
ID
Other
Enumeration date
01/17/2007
Last updated
08/22/2020
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