Organization
ELLINGSEN HENNEBERG PLLC
Active
Parent organization
ELLINGSEN HENNEBERG PLLC
Other names
Smile Source Spokane
Organization subpart
Yes
Provider details
NPI number
Legal business name
ELLINGSEN HENNEBERG PLLC
Authorized official
ERIC C ELLINGSEN DDS (OWNER)
(509) 924-2866
Entity
Organization
Contact information
Practice address
2607 S SOUTHEAST BLVD STE B210, SPOKANE, WA 99223-7614
(509) 924-2866
Mailing address
1215 N MCDONALD RD STE 203, SPOKANE VALLEY, WA 99216-1557
(509) 924-2866
(509) 924-8311
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
10/16/2020
Last updated
10/21/2020
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