Organization
BANICH & BANICH PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JEFFREY BANICH DMD (OWNER/DENTIST)
(509) 684-4586
Entity
Organization
Contact information
Practice address
775 S MAIN ST, SUITE C, COLVILLE, WA 99114-2514
(509) 684-4586
(506) 685-1043
Mailing address
775 S MAIN ST, SUITE C, COLVILLE, WA 99114-2514
(509) 684-4586
(509) 685-1043
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DE60097161
WA
Other
Enumeration date
08/20/2016
Last updated
08/20/2016
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