| Michael A Trantow Dds Ps | |
|
12121 E Broadway Bldg Iii Spokane WA 99206 | |
| (509) 928-3363 | |
| (509) 924-7680 |
| Full Name | Michael A Trantow Dds Ps |
|---|---|
| Speciality | Dental Hygienist |
| Location | 12121 E Broadway, Spokane, Washington |
| Authorized Official Name and Position | Lynn K Trantow (BOOKKEEPER) |
| Authorized Official Contact | 5099283363 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Michael A Trantow Dds Ps 12121 E Broadway Bldg Iii Spokane WA 99206 Ph: (509) 928-3363 | Michael A Trantow Dds Ps 12121 E Broadway Bldg Iii Spokane WA 99206 Ph: (509) 928-3363 |
| NPI Number | 1821197989 |
|---|---|
| Provider Enumeration Date | 09/22/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1821197989 | NPI | - | NPPES |
| 5561006 | Medicaid | WA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | DE00005493 (Washington) | Primary |
| 124Q00000X | Dental Hygienist | DH00001414 (Washington) | Primary |
| 124Q00000X | Dental Hygienist | DH00005591 (Washington) | Primary |
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