Provider Demographics
NPI:1851392658
Name:EKVALL, MERLIN DAVID (DDS, MS)
Entity Type:Individual
Prefix:DR
First Name:MERLIN
Middle Name:DAVID
Last Name:EKVALL
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Gender:M
Credentials:DDS, MS
Other - Prefix:
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Mailing Address - Street 1:800 S. JASMINE STREET
Mailing Address - Street 2:SUITE 4
Mailing Address - City:OMAK
Mailing Address - State:WA
Mailing Address - Zip Code:98841
Mailing Address - Country:US
Mailing Address - Phone:509-826-4831
Mailing Address - Fax:509-826-6741
Practice Address - Street 1:800 JASMINE ST
Practice Address - Street 2:SUITE 4
Practice Address - City:OMAK
Practice Address - State:WA
Practice Address - Zip Code:98841-9501
Practice Address - Country:US
Practice Address - Phone:509-826-4831
Practice Address - Fax:509-826-6741
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-08-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WA71251223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics