Provider Demographics
NPI:1639380991
Name:GEORGE H NAUERT DDS PS
Entity Type:Organization
Organization Name:GEORGE H NAUERT DDS PS
Other - Org Name:10 GRINS
Other - Org Type:Other Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:H
Authorized Official - Last Name:NAUERT
Authorized Official - Suffix:
Authorized Official - Credentials:DDS MS PS
Authorized Official - Phone:509-324-0817
Mailing Address - Street 1:6821 N COUNTRY HOMES BLVD
Mailing Address - Street 2:SUITE 204
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99208-4376
Mailing Address - Country:US
Mailing Address - Phone:509-324-0817
Mailing Address - Fax:509-325-6133
Practice Address - Street 1:6821 N COUNTRY HOMES BLVD
Practice Address - Street 2:SUITE 204
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99208-4376
Practice Address - Country:US
Practice Address - Phone:509-324-0817
Practice Address - Fax:509-325-6133
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-25
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA46551223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Multi-Specialty