Individual
JOHN FAIRBANKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3018 N ARGONNE RD, MILLWOOD, WA 99212-2179
(509) 928-5444
Mailing address
3018 N ARGONNE RD, MILLWOOD, WA 99212-2179
(509) 993-6198
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DENT.DE.70013106
WA
390200000X
Student in an Organized Health Care Education/Training Program
—
TX
Other
Enumeration date
03/02/2023
Last updated
06/03/2025
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