Provider Demographics
NPI:1942216189
Name:VIALE, MICHAEL L (DDS)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:L
Last Name:VIALE
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:105 W 8TH AVE STE 123C
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99204-2323
Mailing Address - Country:US
Mailing Address - Phone:509-474-7498
Mailing Address - Fax:
Practice Address - Street 1:105 W 8TH AVE STE 123C
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99204-2323
Practice Address - Country:US
Practice Address - Phone:509-474-7498
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-31
Last Update Date:2022-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE61055332122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist