| Organization Name: | LITTLE SMILES PEDATRIC DENTISTRY OF NORTH IDAHO |
| NPI Number: | 1023296605 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | BRAD S BARLOW (PRESIDENT) |
| Mailing Address: | 602 N Calgary Ct Suite 201 Post Falls |
| State: | ID US |
| Postal Code: | 838544000 |
| Phone Number: | 2087779331 |
| Fax Number: | 2087779335 |
| NPI Enumeration Date: | 02/05/2008 |
| NPI Last Update Date: | 02/05/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1223P0221X |
| License Number: | D-4050 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| 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. |