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General NPI Number Information
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NPI Number | 1609697119
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Entity Type | Organization
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Legal Business Name | CENTER FOR DENTAL WELLNESS, PLLC
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Dates
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Enumeration Date | 10/18/2024
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Last Update Date | 10/18/2024
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Provider Practice Location Address
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Address Line | 1700 E SCHNEIDMILLER AVE
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City | POST FALLS
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State | ID
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Zip | 83854-7085
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Country | US
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Telephone | 218-443-1811
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Fax |
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Provider Business Mailing Address
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Address Line | 15805 E 23RD AVE
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City | SPOKANE VALLEY
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State | WA
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Zip | 99037-9042
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Country | US
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Telephone | 218-443-1811
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | TAYLOR ZOLLINGER
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Credential | DMD
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Telephone | 218-443-1811
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State |
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