# ERIC C ELLINGSEN DDS PS

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Other names:** Smile Source Spokane
- **Organization subpart:** No

## Provider details

- **NPI number:** 1083169668
- **Authorized official:** DR. ERIC C ELLINGSEN (OWNER)
- **Authorized official phone:** (509) 924-2866

## Contact information

- **Practice address:** 1215 N MCDONALD RD, \#203, SPOKANE VALLEY, WA 99216-1557
- **Practice address phone:** (509) 924-2866
- **Mailing address:** 1215 N MCDONALD RD, \#203, SPOKANE VALLEY, WA 99216-1557
- **Mailing address phone:** (509) 924-2866

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QD0000X | Dental Clinic/Center | 601992748 | WA | Yes |

## Other

- **Enumeration date:** 08/24/2016
- **Last updated:** 08/24/2016