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Id Oms Specialty Dental Services, PLLC — NPI 1245096338, Coeur D Alene, ID | NPI Central

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NPI 1245096338

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Id Oms Specialty Dental Services, PLLC

NPI 1245096338 · Oral and Maxillofacial Surgery (Dentist) · Coeur D Alene, ID

Provider details

NPI number: 1245096338
Entity type: Organization
Primary specialty: Oral and Maxillofacial Surgery (Dentist)Dental Providers
Parent organization: Id Oms Specialty Dental Services, PLLC
Organization subpart: Yes
Authorized official: Charlotte Dasch, Director of Credentialing &pr(504) 638-0303

Specialties & taxonomies

Oral and Maxillofacial Surgery (Dentist)Primary1223S0112X
Dental Providers

Practice location

1859 N Lakewood Dr Ste 101

Coeur D Alene, ID 83814-2661

Phone: (208) 667-5565

Approximate (ZIP-level) locationGet directions

More ID providers

Mailing address

1610 54th Ave N Ste 205

Nashville, TN 37209-1442

Other names (DBA / former)

Doing business as: Implants Northwest

Registry dates

Enumerated: 2024-02-26
Last updated: 2024-02-26
Certified: 2024-02-26

Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.