Organization
JONATHAN M. FAIRBANKS, D.D.S., PLLC
Active
Other names
Pullman Smiles
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JONATHAN MARVIN FAIRBANKS DDS (DENTIST)
(509) 332-7463
Entity
Organization
Contact information
Practice address
1410 SE BISHOP BLVD # 1S, PULLMAN, WA 99163-5419
(509) 334-6700
(509) 334-9239
Mailing address
1410 SE BISHOP BLVD # 1S, PULLMAN, WA 99163-5419
(509) 334-6700
(509) 334-9239
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DE00008587
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5033295
—
WA
Enumeration date
04/15/2010
Last updated
03/16/2012
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