ID SPECIALTY DENTAL SERVICES, PLLC

COEUR D ALENE, ID
NPI1952086845
Doing Business AsRIVERSTONE ORTHODONTICS
Entity TypeOrganization
Authorized ContactCHARLOTTE DASCH
Director Of Credentialing & Prov Re
504-638-0303
Organization Subpart ?Yes
Primary Taxonomy1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics
Enumeration Date2023-06-19
Last Update Date2023-06-19
Business Address
ID SPECIALTY DENTAL SERVICES, PLLC
2140 W RIVERSTONE DR
COEUR D ALENE, ID 83814-4967
Phone number: 208-667-3209
Mailing Address
ID SPECIALTY DENTAL SERVICES, PLLC
1610 54TH AVE N STE 205
NASHVILLE, TN 37209-1442
Phone number: