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General NPI Number Information
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NPI Number | 1952477184
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Entity Type | Organization
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Legal Business Name | DAVID C SPOKANE ORTHODONTIC ASSOCIATION PC
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Dates
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Enumeration Date | 11/28/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 2754 DARLINGTON ROAD
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City | BEAVER FALLS
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State | PA
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Zip | 15010
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Country | US
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Telephone | 724-846-9666
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Fax | 724-846-6663
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Provider Business Mailing Address
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Address Line | 2754 DARLINGTON ROAD
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City | BEAVER FALLS
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State | PA
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Zip | 15010
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Country | US
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Telephone | 724-846-9666
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Fax | 724-846-6663
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Authorized Official
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Title or Position | PRESIDENT
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Name | DAVID C SPOKANE
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Credential | DMD MS
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Telephone | 724-846-9666
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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 | DS027700L
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License Number State | PA
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