MEDICARE: DR. CHARLES E TOILLION DDS

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	1223P0221X	Pediatric Dentistry	8263	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
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1669550778
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CHARLES E TOILLION DDS

Provider Business Mailing Address
First Line	:	1405 E SOUTH RIDGE CT
Second Line	:
City	:	SPOKANE
State	:	WA
Zip	:	99223-6700
Country	:	US
Telephone Number	:	509-448-6695
Fax Number	:	509-755-0444

Provider Business Practice Location Address
First Line	:	605 E HOLLAND AVE STE 222
Second Line	:
City	:	SPOKANE
State	:	WA
Zip	:	99218-1246
Country	:	US
Telephone Number	:	509-755-5437
Fax Number	:	509-755-0444

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/02/2006
Last Update Date	:	07/09/2007

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