Provider Demographics
NPI:1235512229
Name:KEVIN K SANDERS PLLC
Entity Type:Organization
Organization Name:KEVIN K SANDERS PLLC
Other - Org Name:SANDERS FAMILY DENTAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:K
Authorized Official - Last Name:SANDERS
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:509-928-7500
Mailing Address - Street 1:720 N ARGONNE RD
Mailing Address - Street 2:
Mailing Address - City:SPOKANE VALLEY
Mailing Address - State:WA
Mailing Address - Zip Code:99212-2794
Mailing Address - Country:US
Mailing Address - Phone:509-928-7500
Mailing Address - Fax:509-928-0904
Practice Address - Street 1:720 N ARGONNE RD
Practice Address - Street 2:
Practice Address - City:SPOKANE VALLEY
Practice Address - State:WA
Practice Address - Zip Code:99212-2794
Practice Address - Country:US
Practice Address - Phone:509-928-7500
Practice Address - Fax:509-928-0904
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-08
Last Update Date:2015-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE60561209261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental