Organization
DAVIDSON FAMILY DENTAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KIRK MICHAEL DAVIDSON DDS (OWNER)
(208) 667-5447
Entity
Organization
Contact information
Practice address
509 W HANLEY AVE STE 201, COEUR D ALENE, ID 83815-8994
(208) 667-5447
(208) 666-8918
Mailing address
509 W HANLEY AVE STE 201, COEUR D ALENE, ID 83815-8994
(208) 667-5447
(208) 666-8918
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D4322
ID
Other
Enumeration date
11/18/2014
Last updated
11/18/2014
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