Provider Demographics
NPI:1649838426
Name:ARNOLDSON, DENIM (DDS)
Entity type:Individual
Prefix:DR
First Name:DENIM
Middle Name:
Last Name:ARNOLDSON
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 1:20800 N 12000 E
Mailing Address - Street 2:
Mailing Address - City:FAIRVIEW
Mailing Address - State:UT
Mailing Address - Zip Code:84629-5694
Mailing Address - Country:US
Mailing Address - Phone:782-414-4457
Mailing Address - Fax:
Practice Address - Street 1:15810 E INDIANA AVE
Practice Address - Street 2:
Practice Address - City:SPOKANE VALLEY
Practice Address - State:WA
Practice Address - Zip Code:99216-1864
Practice Address - Country:US
Practice Address - Phone:509-940-0192
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-05
Last Update Date:2019-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA609683141223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice