Kalispel Tribe of Indians

NPI #1083980080 in Cusick, Washington

Provider Information

NPI Number: 1083980080
Entity Type: Organization
Organization Name: Kalispel Tribe of Indians
Primary Specialty: Dentist
Enumeration Date: Mar 24, 2012
Last Updated: Sep 13, 2023

Practice Location

Address: 1821 LECLERC RD N STE 1
City: Cusick
State: Washington
ZIP Code: 99119-5015
Phone: (509) 447-7111

Authorized Official

Name: TRACY LYNN BIRDTAIL
Title: AM
Phone: (509) 447-7112

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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