# TRAILHEAD DENTAL

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

## Provider details

- **NPI number:** 1548119720
- **Authorized official:** JACOB STORER DMD (OWNER)
- **Authorized official phone:** (509) 503-1115

## Contact information

- **Practice address:** 5011 W LOWELL AVE STE 120, SPOKANE, WA 99208-8587
- **Practice address phone:** (509) 503-1115
- **Practice address fax:** (509) 503-1099
- **Mailing address:** 5011 W LOWELL AVE STE 120, SPOKANE, WA 99208-8587
- **Mailing address phone:** (509) 503-1115
- **Mailing address fax:** (509) 503-1099

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QD0000X | Dental Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 01/22/2026
- **Last updated:** 01/22/2026