Provider Demographics
NPI:1841597424
Name:NORTHVIEW FAMILY DENTAL, PLLC
Entity type:Organization
Organization Name:NORTHVIEW FAMILY DENTAL, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:W
Authorized Official - Last Name:LEALE
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:509-489-2538
Mailing Address - Street 1:5901 N LIDGERWOOD ST STE 225
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99208-1122
Mailing Address - Country:US
Mailing Address - Phone:509-489-2538
Mailing Address - Fax:509-487-7197
Practice Address - Street 1:5901 N LIDGERWOOD ST STE 225
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99208-1122
Practice Address - Country:US
Practice Address - Phone:509-489-2538
Practice Address - Fax:509-487-7197
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-02-17
Last Update Date:2011-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE000109051223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty