MEDICARE: OLA J. ENGLUND, D.D.S., P.S.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	8323	WA
2	1223G0001X	General Practice Dentistry	4850	WA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1124234042
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	OLA J. ENGLUND, D.D.S., P.S.

Provider Business Mailing Address
First Line	:	6817 N CEDAR RD STE 201
Second Line	:
City	:	SPOKANE
State	:	WA
Zip	:	99208-4277
Country	:	US
Telephone Number	:	509-326-8170
Fax Number	:	509-326-8172

Provider Business Practice Location Address
First Line	:	6817 N CEDAR RD STE 201
Second Line	:
City	:	SPOKANE
State	:	WA
Zip	:	99208-4277
Country	:	US
Telephone Number	:	509-326-8170
Fax Number	:	509-326-8172

Authorized Official
Title or Position	:	BUSINESS MANAGER
Name	:	ELSA BURK
Credential	:
Telephone Number	:	509-326-8170

Provider Enumeration Date	:	05/15/2007
Last Update Date	:	08/22/2020

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