Provider Demographics
NPI:1609904754
Name:SAITO, SPENCER A (DDS)
Entity Type:Individual
Prefix:MR
First Name:SPENCER
Middle Name:A
Last Name:SAITO
Suffix:
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:PO BOX 141629
Mailing Address - Street 2:12525 E MISSION SUITE 101
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99214
Mailing Address - Country:US
Mailing Address - Phone:509-924-9811
Mailing Address - Fax:509-924-0640
Practice Address - Street 1:12525 E MISSION
Practice Address - Street 2:#101
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99206
Practice Address - Country:US
Practice Address - Phone:509-924-9811
Practice Address - Fax:509-924-0640
Is Sole Proprietor?:No
Enumeration Date:2007-03-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA35391223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice