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Organization
ELLINGSEN HENNEBERG PLLC
Active
Organization
ELLINGSEN HENNEBERG PLLC
Active
Other names
Smile Source Spokane, Smile Source North
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ERIC ELLINGSEN DDS (OWNER)
(509) 924-2866
Entity
Organization
Contact information
Practice address
6817 N CEDAR RD STE 201, SPOKANE, WA 99208-4277
(509) 326-8170
Mailing address
1215 N MCDONALD RD STE 203, SPOKANE VALLEY, WA 99216-1557
(509) 924-2866
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
NULL
122300000X
Dentist
Primary
—
—
Other
Enumeration date
08/02/2019
Last updated
08/02/2019
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