Organization
SPOKANE ORAL AND MAXILLOFACIAL SURGERY ASC
Active
Parent organization
SPOKANE OMS PLLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
SPOKANE OMS PLLC
Authorized official
MS. RENEE K BANCROFT (BILLING MANAGER)
(509) 926-7106
Entity
Organization
Contact information
Practice address
12109 E BROADWAY AVE, BUILDING C, SPOKANE VALLEY, WA 99206-6133
(509) 926-7106
(509) 926-2833
Mailing address
12109 E BROADWAY AVE, BUILDING C, SPOKANE VALLEY, WA 99206-6133
(509) 926-7106
(509) 926-2833
Taxonomy
Speciality
Code
Description
License number
State
261QS0112X
Oral and Maxillofacial Surgery Clinic/Center
Primary
—
WA
Other
Enumeration date
04/02/2013
Last updated
04/02/2013
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