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General NPI Number Information
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NPI Number | 1962169029
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Entity Type | Organization
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Legal Business Name | ELLINGSEN AND DENISON ENDODONTICS, PLLC
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Dates
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Enumeration Date | 11/23/2021
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Last Update Date | 11/24/2021
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Provider Practice Location Address
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Address Line | 1005 N EVERGREEN RD STE 201
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City | SPOKANE VALLEY
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State | WA
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Zip | 99216-1485
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Country | US
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Telephone | 509-921-5666
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Fax | 509-927-4842
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Provider Business Mailing Address
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Address Line | 1005 N EVERGREEN RD STE 201
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City | SPOKANE VALLEY
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State | WA
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Zip | 99216-1485
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Country | US
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Telephone | 509-921-5666
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Fax | 509-927-4842
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Authorized Official
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Title or Position | MEMBER
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Name | DR. ELISE ELLINGSEN MILLER
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Credential | DDS MSD
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Telephone | 509-921-5666
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223E0200X
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Taxonomy Name | Endodontics
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License Number |
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License Number State |
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