Provider Demographics
NPI:1033665880
Name:MILLWOOD FAMILY DENTAL INC
Entity Type:Organization
Organization Name:MILLWOOD FAMILY DENTAL INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE COORDINATOR
Authorized Official - Prefix:
Authorized Official - First Name:MELYNA
Authorized Official - Middle Name:
Authorized Official - Last Name:HOBBS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:509-928-5444
Mailing Address - Street 1:3018 N ARGONNE RD
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99212-2179
Mailing Address - Country:US
Mailing Address - Phone:509-928-5444
Mailing Address - Fax:509-928-5404
Practice Address - Street 1:3018 N ARGONNE RD
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99212-2179
Practice Address - Country:US
Practice Address - Phone:509-928-5444
Practice Address - Fax:509-928-5404
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-31
Last Update Date:2016-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA8746261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental