Healthcare Provider Details

I. General information

NPI: 1316494537
Provider Name (Legal Business Name): DR. TIMOTHY L SWEATMAN DDS PS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/06/2016
Last Update Date: 09/06/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

775 E HOLLAND AVE STE 202
SPOKANE WA
99218-5016
US

IV. Provider business mailing address

775 E HOLLAND AVE STE 202
SPOKANE WA
99218-5016
US

V. Phone/Fax

Practice location:
  • Phone: 509-468-7744
  • Fax: 509-468-7544
Mailing address:
  • Phone: 509-468-7744
  • Fax: 509-468-7544

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223E0200X
TaxonomyEndodontics
License NumberDE00007902
License Number StateWA

VIII. Authorized Official

Name: DR. TIMOTHY L. SWEATMAN
Title or Position: OWNER
Credential:
Phone: 509-468-7744