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Contact Information

LAKE CITY DENTAL SPECIALTIES, PC
1322 W KATHLEEN AVE STE 2
COEUR D'ALENE, ID83815-7365
 Phone: 208-664-7300
 Fax: 208-664-7333
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Periodontics

1223P0300X
 

Endodontics

1223E0200X
Indicates primary specialty

NPI Profile & details for LAKE CITY DENTAL SPECIALTIES, PC

NPI Number 1356693915
LBN Legal business name LAKE CITY DENTAL SPECIALTIES, PC
Authorized official SHAUN WHITNEY - (PRESIDENT)
Entity Organization
Organization subpart 1 No
Enumeration date 10/07/2012
Last updated 10/07/2012 - About 14 years ago
Identifiers
ID License # D4420EN
ID License # D4420PE
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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