Individual
JONATHAN M. FAIRBANKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
1410 SE BISHOP BLVD, PULLMAN, WA 99163-5419
(509) 332-2329
(506) 334-9239
Mailing address
910 SE HIGH ST, PULLMAN, WA 99163-2230
(509) 332-7463
(509) 332-5456
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
8587
WA
Other
Enumeration date
04/25/2007
Last updated
07/08/2007
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