Healthcare Provider Details

I. General information

NPI: 1194632554
Provider Name (Legal Business Name): CAMERON HART DDS PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/24/2026
Last Update Date: 08/24/2026
Certification Date: 08/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2615 N FRUITLAND LN
COEUR D ALENE ID
83815-7914
US

IV. Provider business mailing address

303 AVIATOR AVE
SANDPOINT ID
83864-2089
US

V. Phone/Fax

Practice location:
  • Phone: 360-270-5062
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number
License Number State

VIII. Authorized Official

Name: DR. CAMERON HART
Title or Position: DENTIST
Credential: DDS
Phone: 360-270-5062