Organization
MANITO FAMILY DENTISTRY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MITCHELL J ORSI DDS (DENTIST/OWNER)
(509) 456-8676
Entity
Organization
Contact information
Practice address
3615 S GRAND BLVD, SPOKANE, WA 99203-2624
(509) 456-8676
(509) 456-8678
Mailing address
3615 S GRAND BLVD, SPOKANE, WA 99203-2624
(509) 456-8676
(509) 456-8678
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
6172
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
56172
DELTA DENTAL OF WASHINGTON
WA
Enumeration date
08/16/2016
Last updated
08/16/2016
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