Healthcare Provider Details

I. General information

NPI: 1861927675
Provider Name (Legal Business Name): DEVIN MORIN DMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/30/2017
Last Update Date: 09/30/2021
Certification Date: 09/30/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6501 N CEDAR RD BLDG 2
SPOKANE WA
99208-4571
US

IV. Provider business mailing address

1110 E SILVER PINE RD
COLBERT WA
99005-5125
US

V. Phone/Fax

Practice location:
  • Phone: 509-312-3200
  • Fax:
Mailing address:
  • Phone: 502-712-9561
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1223P0221X
TaxonomyPediatric Dentistry
License NumberDE60976645
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code1223P0221X
TaxonomyPediatric Dentistry
License NumberD-5073-PD
License Number StateID

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: