Organization · Type 2 NPI
Shadle Smile Source PLLC
Dental Clinic/Center · Spokane, WA
NPI number
1154083822
Active
Practice location
4610 N Ash St Ste 2O1
Spokane, WA 99205-1482
Mailing address
2513 N Chase Ln
Liberty Lake, WA 99019-7533
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Dental Clinic/Center Primary | 261QD0000X | None listed |
Dental Clinic/Center: Definition to come...
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About NPI 1154083822
Shadle Smile Source PLLC's National Provider Identifier is 1154083822, issued on Oct 11, 2021. The primary taxonomy on file is Dental Clinic/Center (261QD0000X), and the practice location is in Spokane, WA. The record was last updated on Oct 11, 2021.