| Spokane Oral And Maxillofacial Surgery | |
|
12109 E Broadway Ave Bldg C Spokane Valley WA 99206-6133 | |
| (509) 893-3635 | |
| (509) 926-2833 |
| Full Name | Spokane Oral And Maxillofacial Surgery |
|---|---|
| Speciality | Dentist - Oral And Maxillofacial Surgery |
| Location | 12109 E Broadway Ave, Spokane Valley, Washington |
| Authorized Official Name and Position | Renee Kristen Bancroft (ADMINISTRATIVE MANAGER) |
| Authorized Official Contact | 50989393635 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Spokane Oral And Maxillofacial Surgery 12109 E Broadway Ave Bldg C Spokane Valley WA 99206-6133 Ph: (509) 893-3635 | Spokane Oral And Maxillofacial Surgery 12109 E Broadway Ave Bldg C Spokane Valley WA 99206-6133 Ph: (509) 893-3635 |
| NPI Number | 1023409877 |
|---|---|
| Provider Enumeration Date | 02/16/2015 |
| Last Update Date | 02/16/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1023409877 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | D5470 (Washington) | Primary |
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