Healthcare Provider Details

I. General information

NPI: 1629541552
Provider Name (Legal Business Name): ZOLLINGER, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/03/2019
Last Update Date: 07/20/2021
Certification Date: 07/20/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3022 E 57TH AVE STE 10
SPOKANE WA
99223-7033
US

IV. Provider business mailing address

3022 E 57TH AVE STE 10
SPOKANE WA
99223-7033
US

V. Phone/Fax

Practice location:
  • Phone: 509-443-8910
  • Fax: 594-443-8911
Mailing address:
  • Phone: 509-443-8910
  • Fax: 594-443-8911

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QD0000X
TaxonomyDental Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: BRYANT ZOLLINGER
Title or Position: DENTIST
Credential: DDS
Phone: 509-443-8910