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Organization
BANICH FAMILY DENTAL
Active
Organization
BANICH FAMILY DENTAL
Active
Other names
Steven G. Banich DDS PLLC
Organization subpart
No
Provider details
NPI number
Authorized official
MISS JULIE ANN MACE (OFFICE MANAGER)
(509) 684-4586
Entity
Organization
Contact information
Practice address
775 S MAIN ST, STE C, COLVILLE, WA 99114-2514
(509) 684-4586
(509) 685-1043
Mailing address
775 S MAIN ST, STE C, COLVILLE, WA 99114-2514
(509) 684-4586
(509) 685-1043
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
606128-00-5
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5513106
—
WA
Enumeration date
09/22/2010
Last updated
09/22/2010
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