| Organization Name: | PALOUSE PEDIATRIC DENTISTRY |
| NPI Number: | 1013175595 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | KAREN M SEPT (OWNER) |
| Mailing Address: | 1246 W A St Moscow |
| State: | ID US |
| Postal Code: | 838432277 |
| Phone Number: | 2088829999 |
| Fax Number: | 2088829998 |
| NPI Enumeration Date: | 05/30/2008 |
| NPI Last Update Date: | 05/30/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1223P0221X |
| License Number: | D-4108-PD |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | ID |
| Taxonomy Type: | Dental Providers |
| Taxonomy Classification: | Dentist |
| Taxonomy Specialization: | Pediatric Dentistry |
| Taxonomy 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. |