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General NPI Number Information
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NPI Number | 1053657049
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Entity Type | Organization
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Legal Business Name | BRIDGET REILLY SHEAHAN DDS PLLC
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Dates
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Enumeration Date | 12/18/2012
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Last Update Date | 08/26/2013
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Provider Practice Location Address
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Address Line | 3144 E 29TH AVE
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City | SPOKANE
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State | WA
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Zip | 99223-4848
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Country | US
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Telephone | 509-536-8888
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Fax | 509-536-8894
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Provider Business Mailing Address
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Address Line | 3144 E 29TH AVE
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City | SPOKANE
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State | WA
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Zip | 99223-4848
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Country | US
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Telephone | 509-536-8888
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Fax | 509-536-8894
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Authorized Official
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Title or Position | MEMBER
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Name | DR. BRIDGET REILLY SHEAHAN
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Credential | DDS
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Telephone | 509-536-8888
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 00010579
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License Number State | WA
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