| Inland Oral Surgery P.s. | |
|
2204 E 29th Ave Suite 104 Spokane WA 99203-3961 | |
| (509) 321-1404 | |
| (509) 321-0211 |
| Full Name | Inland Oral Surgery P.s. |
|---|---|
| Speciality | Dentist - Oral And Maxillofacial Surgery |
| Location | 2204 E 29th Ave, Spokane, Washington |
| Authorized Official Name and Position | W. Dale Crum (OWNER) |
| Authorized Official Contact | 5099534067 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Inland Oral Surgery P.s. 2204 E 29th Ave Suite 104 Spokane WA 99203-3961 Ph: (509) 321-1404 | Inland Oral Surgery P.s. 2204 E 29th Ave Suite 104 Spokane WA 99203-3961 Ph: (509) 321-1404 |
| NPI Number | 1982965976 |
|---|---|
| Provider Enumeration Date | 06/06/2012 |
| Last Update Date | 06/06/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1982965976 | NPI | - | NPPES |
| 1609870070 | Medicaid | WA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | DE00007006 (Washington) | Primary |
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