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Shadle Smile Source Pllc
Dental Clinic/Center in Spokane, Washington
NPI 1154083822

Shadle Smile Source Pllc is a Dental Clinic/Center based in Liberty Lake, WA and is specialized in Dental. Shadle Smile Source Pllc practices in Spokane, WA. The NPI Number for Shadle Smile Source Pllc is 1154083822 and holds a License No. (Washington).

The current practice location address for Shadle Smile Source Pllc is 4610 N Ash St Ste 2O1, Spokane, WA and can be reached out via phone at 509-325-4313.

Location: 4610 N Ash St Ste 2O1, Spokane, WA, 99019-7533
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1154083822
Provider Name
Shadle Smile Source Pllc
Credential
Provider Entity Type
Organization
Address
4610 N Ash St Ste 2O1, Spokane, WA, 99019-7533
Phone Number
509-325-4313
Fax Number
Provider Enumeration Date
10/11/2021
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
4610 N Ash St Ste 2O1
City
Spokane
State
Washington
Zip
99205-1482
Phone Number
509-325-4313
Fax Number
person
Provider Business Mailing Address Details
Address
4610 N Ash St Ste 2O1
City
Spokane
State
Washington
Zip
99205-1482
Phone Number
509-325-4313
Fax Number
person
Provider's Taxonomy Details 1
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
Dental
Taxonomy
261QD0000X
License No.
()
Definition
Definition to come...
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