# EVERGREEN COSMETIC & FAMILY DENTISTRY

> 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
- **Organization subpart:** No

## Provider details

- **NPI number:** 1497796130
- **Authorized official:** MRS. AMY SINES (FINANCIAL COORDINATOR)
- **Authorized official phone:** (509) 928-4191

## Contact information

- **Practice address:** 1005 N EVERGREEN RD, SUITE \#202, SPOKANE VALLEY, WA 99216-1485
- **Practice address phone:** (509) 928-4191
- **Practice address fax:** (509) 921-5942
- **Mailing address:** 1005 N EVERGREEN RD, SUITE \#202, SPOKANE VALLEY, WA 99216-1485
- **Mailing address phone:** (509) 928-4191
- **Mailing address fax:** (509) 921-5942

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | — | NULL | Yes |
| 1223G0001X | General Practice Dentistry | — | — | Yes |

## Other

- **Enumeration date:** 06/10/2006
- **Last updated:** 08/22/2020