Provider Demographics
NPI:1659596948
Name:ENGEN, DAVID WAYNE (DDS, MSD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:WAYNE
Last Name:ENGEN
Suffix:
Gender:M
Credentials:DDS, MSD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:9911 N NEVADA ST STE 110
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99218-1298
Mailing Address - Country:US
Mailing Address - Phone:509-326-4445
Mailing Address - Fax:509-326-4612
Practice Address - Street 1:9911 N NEVADA ST STE 110
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99218
Practice Address - Country:US
Practice Address - Phone:509-326-4445
Practice Address - Fax:509-326-4612
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-13
Last Update Date:2021-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA86811223X0400X, 1223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics
No1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics