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Palouse Pediatric Dentistry
Pediatric Dentist in Moscow, Idaho
NPI 1013175595

Palouse Pediatric Dentistry is a Pediatric Dentist based in Moscow, ID and is specialized in Pediatric Dentistry. Palouse Pediatric Dentistry practices in Moscow, ID. The NPI Number for Palouse Pediatric Dentistry is 1013175595 and holds a License No. D-4108-PD (Idaho).

The current practice location address for Palouse Pediatric Dentistry is 1246 W A St, Moscow, ID and can be reached out via phone at 208-882-9999 and via fax at 208-882-9998.

Location: 1246 W A St, Moscow, ID, 83843-2277
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1013175595
Provider Name
Palouse Pediatric Dentistry
Credential
Provider Entity Type
Organization
Address
1246 W A St, Moscow, ID, 83843-2277
Phone Number
208-882-9999
Fax Number
208-882-9998
Provider Enumeration Date
05/30/2008
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
807993200 05 ID
institution
Provider Business Practice Location Address Details
Address
1246 W A St
City
Moscow
State
Idaho
Zip
83843-2277
Phone Number
208-882-9999
Fax Number
208-882-9998
person
Provider Business Mailing Address Details
Address
1246 W A St
City
Moscow
State
Idaho
Zip
83843-2277
Phone Number
208-882-9999
Fax Number
208-882-9998
person
Provider's Taxonomy Details 1
Type
Dental Providers
Classification
Dentist
Speciality
Pediatric Dentistry
Taxonomy
1223P0221X
License No.
D-4108-PD (Idaho)
Definition
An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs.
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