Healthcare Provider Details
I. General information
NPI: 1740368869
Provider Name (Legal Business Name): ANDREW H GARABEDIAN DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 11/02/2006
Last Update Date: 07/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
605 E HOLLAND AVE STE 222
SPOKANE WA
99218-1246
US
IV. Provider business mailing address
2215 S GARFIELD RD
SPOKANE WA
99203-3303
US
V. Phone/Fax
- Phone: 509-755-5437
- Fax: 509-755-0444
- Phone: 509-456-2027
- Fax: 509-755-0444
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 1223P0221X |
| Taxonomy | Pediatric Dentistry |
| License Number | 9251 |
| License Number State | WA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: