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12109 E Broadway Ave Ste B Spokane Valley WA 99206-6133 | |
| (509) 926-0570 | |
| (509) 921-9163 |
| Full Name | |
|---|---|
| Speciality | Dentist - Orthodontics And Dentofacial Orthopedics |
| Location | 12109 E Broadway Ave Ste B, Spokane Valley, Washington |
| Authorized Official Name and Position | Richard C Ellingsen (PRESIDENT) |
| Authorized Official Contact | 5099260570 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
12109 E Broadway Ave Ste B Spokane Valley WA 99206-6133 Ph: (509) 926-0570 | 12109 E Broadway Ave Ste B Spokane Valley WA 99206-6133 Ph: (509) 926-0570 |
| NPI Number | 1558446278 |
|---|---|
| Provider Enumeration Date | 10/25/2006 |
| Last Update Date | 11/19/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1558446278 | NPI | - | NPPES |
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Brent M Williams Dds Ps Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 420 N Evergreen Rd, Suite 400 Building B, Spokane Valley, WA 99216 Phone: 509-922-1360 Fax: 509-922-1260 | |
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