# JASON TUCKER DDS PLLC

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

## Provider details

- **NPI number:** 1407309909
- **Authorized official:** JASON R TUCKER DDS (DENTIST)
- **Authorized official phone:** (509) 448-5888

## Contact information

- **Practice address:** 2718 E 57TH AVE, SPOKANE, WA 99223-6605
- **Practice address phone:** (509) 448-5888
- **Mailing address:** 2718 E 57TH AVE, SPOKANE, WA 99223-6605
- **Mailing address phone:** (509) 448-5888

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QD0000X | Dental Clinic/Center | 60111978 | WA | Yes |

## Other

- **Enumeration date:** 08/01/2016
- **Last updated:** 08/01/2016