| Mydentist | |
|
915 East Hawthorne Road Suite G Spokane WA 99218 | |
| (509) 464-4100 | |
| (509) 464-4104 |
| Full Name | Mydentist |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 915 East Hawthorne Road, Spokane, Washington |
| Authorized Official Name and Position | Stephen C Call (DENTIST OWNER) |
| Authorized Official Contact | 5094644100 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mydentist 915 East Hawthorne Road Suite G Spokane WA 99218 Ph: (509) 464-4100 | Mydentist 915 East Hawthorne Road Suite G Spokane WA 99218 Ph: (509) 464-4100 |
| NPI Number | 1497967517 |
|---|---|
| Provider Enumeration Date | 05/03/2007 |
| Last Update Date | 08/01/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1497967517 | NPI | - | NPPES |
| DE00008830 | Other | WA | STATE DENTAL LICENSE |
| 8830 (2-8830) | Other | WA | 915 E HAWTHORNE LOCATION |
| 8830 (5-8830) | Other | WA | 212 W BIRCH LOCATION |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | DE00008830 (Washington) | Primary |
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