Provider Demographics
NPI:1679865166
Name:DAMON ORTHODONTICS, PLLC
Entity Type:Organization
Organization Name:DAMON ORTHODONTICS, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SENIOR PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CLAY
Authorized Official - Middle Name:H
Authorized Official - Last Name:DAMON
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:509-448-2600
Mailing Address - Street 1:4102 S REGAL ST
Mailing Address - Street 2:SUITE 104
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99223-5083
Mailing Address - Country:US
Mailing Address - Phone:509-448-2600
Mailing Address - Fax:509-448-2643
Practice Address - Street 1:4102 S REGAL ST
Practice Address - Street 2:SUITE 104
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99223-5083
Practice Address - Country:US
Practice Address - Phone:509-448-2600
Practice Address - Fax:509-448-2643
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-05-03
Last Update Date:2013-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty