Organization
KOOTENAI FAMILY DENTAL, PA
Active
Other names
Kootenai Family Dental, PA
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ROBERT L WILDER DDS (DENTIST)
(208) 664-8283
Entity
Organization
Contact information
Practice address
1420 LINCOLN WAY, SUITE 200, COEUR DALENE, ID 83814
(208) 664-8283
(208) 667-0794
Mailing address
1420 LINCOLN WAY, SUITE 200, COEUR DALENE, ID 83814
(208) 664-8283
(208) 667-0794
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
3794
ID
Other
Enumeration date
08/25/2006
Last updated
10/06/2008
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