Provider Demographics
NPI:1669834859
Name:GRIFFITH, STEPHEN (DMD)
Entity Type:Individual
Prefix:
First Name:STEPHEN
Middle Name:
Last Name:GRIFFITH
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3707 S GRAND BLVD STE B
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99203-2762
Mailing Address - Country:US
Mailing Address - Phone:509-838-2434
Mailing Address - Fax:844-272-8013
Practice Address - Street 1:3707 S GRAND BLVD STE B
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99203-2762
Practice Address - Country:US
Practice Address - Phone:509-838-2434
Practice Address - Fax:844-272-8013
Is Sole Proprietor?:No
Enumeration Date:2016-03-25
Last Update Date:2019-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
WA60756826122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program