Individual
ELIZABETH ICENOGLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.M.D.
Contact information
Practice address
3415 W HORIZON AVE, SPOKANE, WA 99208-8493
(509) 954-5625
Mailing address
3415 W HORIZON AVE, SPOKANE, WA 99208-8493
(509) 954-5625
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DE 60667608
WA
Other
Enumeration date
08/09/2016
Last updated
08/09/2016
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