# BANICH FAMILY DENTAL

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Steven G. Banich DDS PLLC
- **Organization subpart:** No

## Provider details

- **NPI number:** 1730497983
- **Authorized official:** MISS JULIE ANN MACE (OFFICE MANAGER)
- **Authorized official phone:** (509) 684-4586

## Contact information

- **Practice address:** 775 S MAIN ST, STE C, COLVILLE, WA 99114-2514
- **Practice address phone:** (509) 684-4586
- **Practice address fax:** (509) 685-1043
- **Mailing address:** 775 S MAIN ST, STE C, COLVILLE, WA 99114-2514
- **Mailing address phone:** (509) 684-4586
- **Mailing address fax:** (509) 685-1043

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | 606128-00-5 | WA | Yes |

## Other

- **Enumeration date:** 09/22/2010
- **Last updated:** 09/22/2010

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 5513106 | — | WA |