Organization
DEER PARK DENTAL PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SANDY FLETCHER MONTANO DDS (OWNER)
(786) 955-7284
Entity
Organization
Contact information
Practice address
118 E. CRAWFORD ST., DEER PARK, WA 99006
(509) 850-8061
Mailing address
PO BOX 18184, SPOKANE, WA 99228-0184
(509) 850-8061
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2085276
—
WA
Enumeration date
06/11/2020
Last updated
10/21/2020
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