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NPI Code Detail

MEDICARE: MICHAEL GRISHIN DN

MEDICARE:   MICHAEL  GRISHIN  DN
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
1122400000XDenturistDN60404130WA

General Provider Information

NPI Number : 1407305816
Entity Type Code : Individual
Provider Name (Legal Business Name) : MICHAEL GRISHIN DN
Provider Business Mailing Address
First Line : 2514 N MADELIA ST
Second Line :
City : SPOKANE
State : WA
Zip : 99207-5074
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 104 S FREYA ST STE 213A
Second Line :
City : SPOKANE
State : WA
Zip : 99202-4868
Country : US
Telephone Number : 509-768-2097
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/26/2016
Last Update Date : 09/26/2016

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Directions to “ MICHAEL GRISHIN DN” Practice Location

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