Organization
DAMOM & MAGNUSON ORTHODONTICS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SHANNON MAGNUSON (ORTHODONTIST)
(506) 924-9860
Entity
Organization
Contact information
Practice address
12406 E MISSION AVE, SPOKANE VALLEY, WA 99216-1051
(506) 924-9860
(509) 926-0818
Mailing address
12406 E MISSION AVE, SPOKANE VALLEY, WA 99216-1051
(506) 924-9860
(509) 926-0818
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
3458
WA
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
7628
WA
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
7718
WA
Other
Enumeration date
11/17/2006
Last updated
08/22/2020
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