Organization · Type 2 NPI

Id Oms Specialty Dental Services, PLLC

Oral and Maxillofacial Surgery (Dentist) · Coeur D Alene, ID

NPI number 1245096338 Active

Practice location

1859 N Lakewood Dr Ste 101
Coeur D Alene, ID 83814-2661

Call (208) 667-5565 Map

Mailing address

1610 54th Ave N Ste 205
Nashville, TN 37209-1442

Specialties and licenses

Taxonomy	Code	License
Oral and Maxillofacial Surgery (Dentist) Primary	1223S0112X	None listed

Oral and Maxillofacial Surgery (Dentist): The specialty of dentistry which includes the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region.

2 other providers at this address

Other oral and maxillofacial surgery (dentist) providers in Coeur D Alene

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NPI record

NPI: 1245096338
Entity type: Organization (Type 2)
Issued: Feb 26, 2024
Last updated: Feb 26, 2024
Status: Active
Subpart: Yes of Id Oms Specialty Dental Services, PLLC

Other names

Implants Northwest · doing business as

Authorized official

Charlotte Dasch
Director of Credentialing &pr
(504) 638-0303

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This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1245096338

Id Oms Specialty Dental Services, PLLC's National Provider Identifier is 1245096338, issued on Feb 26, 2024. The primary taxonomy on file is Oral and Maxillofacial Surgery (Dentist) (1223S0112X), and the practice location is in Coeur D Alene, ID. The record was last updated on Feb 26, 2024.