# CANNON HILL DENTAL

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1154876464
- **Authorized official:** ABBY BOWERMAN (MANAGER)
- **Authorized official phone:** (509) 624-5590

## Contact information

- **Practice address:** 1424 S BERNARD ST, SPOKANE, WA 99203-5008
- **Practice address phone:** (509) 624-5590
- **Practice address fax:** (509) 747-0483
- **Mailing address:** 1424 S BERNARD ST, SPOKANE, WA 99203-5008
- **Mailing address phone:** (509) 624-5590
- **Mailing address fax:** (509) 747-0483

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | — | NULL | Yes |
| 122300000X | Dentist | — | — | Yes |

## Other

- **Enumeration date:** 08/17/2016
- **Last updated:** 08/17/2016

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 5028964 | — | WA |