Provider Demographics
NPI:1447224035
Name:MOLGARD, MAX H JR (DDS)
Entity Type:Individual
Prefix:DR
First Name:MAX
Middle Name:H
Last Name:MOLGARD
Suffix:JR
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6817 N CEDAR RD
Mailing Address - Street 2:SUITE 102
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99208-4277
Mailing Address - Country:US
Mailing Address - Phone:509-327-4469
Mailing Address - Fax:509-328-9902
Practice Address - Street 1:6817 N CEDAR RD
Practice Address - Street 2:SUITE 102
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99208-4277
Practice Address - Country:US
Practice Address - Phone:509-327-4469
Practice Address - Fax:509-328-9902
Is Sole Proprietor?:No
Enumeration Date:2006-02-13
Last Update Date:2016-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE605470381223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0700XDental ProvidersDentistProsthodontics