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General NPI Number Information
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NPI Number | 1427324037
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Entity Type | Organization
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Legal Business Name | CHRISTOPHER S. SPAIN, DDS, PLLC
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Dates
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Enumeration Date | 03/28/2012
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Last Update Date | 09/21/2016
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Provider Practice Location Address
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Address Line | 2015 TERRY AVE APT 406
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City | SEATTLE
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State | WA
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Zip | 98121-2745
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Country | US
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Telephone | 206-349-9009
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Fax |
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Provider Business Mailing Address
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Address Line | 19929 BALLINGER WAY NE STE 201
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City | SHORELINE
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State | WA
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Zip | 98155-8208
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Country | US
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Telephone | 206-693-3123
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Fax |
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Authorized Official
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Title or Position | ORTHODONTIST
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Name | DR. CHRISTOPHER SPAIN
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Credential | DDS, MSD
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Telephone | 206-349-9009
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | DE60220488
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License Number State | WA
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