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Id Oms Specialty Dental Services, PLLC — NPI 1366119075, Coeur D Alene, ID | NPI Central

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NPI 1366119075

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Id Oms Specialty Dental Services, PLLC

NPI 1366119075 · Oral and Maxillofacial Surgery (Dentist) · Coeur D Alene, ID

Provider details

NPI number: 1366119075
Entity type: Organization
Primary specialty: Oral and Maxillofacial Surgery (Dentist)Dental Providers
Organization subpart: No
Authorized official: Charlotte Dasch, Director of Provider Relations(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

401 Church St Ste 1400

Nashville, TN 37219-2214

Other names (DBA / former)

Other name: Specialty Dental Brands

Registry dates

Enumerated: 2021-08-30
Last updated: 2021-08-30
Certified: 2021-08-30

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