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Organization

COLLINS ORAL & MAXILLOFACIAL SURGERY, PS

Active
Organization subpart
No

Provider details

NPI number
Authorized official
KRISTIN HUMPHREY (OFFICE MANAGER)
(509) 624-2204
Entity
Organization

Contact information

Practice address
322 W 7TH AVE, SPOKANE, WA 99204-2504
(509) 624-2202
Mailing address
322 W 7TH AVE, SPOKANE, WA 99204-2504
(509) 624-2202

Taxonomy

Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
5035753
WA
Enumeration date
11/15/2007
Last updated
02/13/2009
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