| Maple Street Family Dentistry | |
|
4610 N Ash St Suite 102 Spokane WA 99205-1482 | |
| (509) 891-5001 | |
| (509) 891-2787 |
| Full Name | Maple Street Family Dentistry |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 4610 N Ash St, Spokane, Washington |
| Authorized Official Name and Position | Michelle Renee Olmstead (OWNER/DENTIST) |
| Authorized Official Contact | 5098915001 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Maple Street Family Dentistry 1328 N Stanford Ln Suite 100 Liberty Lake WA 99019-5034 Ph: (509) 891-5001 | Maple Street Family Dentistry 4610 N Ash St Suite 102 Spokane WA 99205-1482 Ph: (509) 891-5001 |
| NPI Number | 1235509639 |
|---|---|
| Provider Enumeration Date | 09/29/2015 |
| Last Update Date | 09/29/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1235509639 | NPI | - | NPPES |
| 5032438 | Medicaid | WA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | DE00008465 (Washington) | Primary |
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