Organization
SPOKANE OMS
Active
Other names
Spokane Oral & Maxillofacial Surgery
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MARLA A TELIN (COO)
(509) 926-7106
Entity
Organization
Contact information
Practice address
12109 E BROADWAY AVENUE SUITE C, SPOKANE VALLEY, WA 99206-6133
(509) 926-7106
(509) 926-2833
Mailing address
12109 E BROADWAY AVE STE C, SPOKANE VALLEY, WA 99206-6133
(509) 926-7106
(509) 926-2833
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
—
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5036579
—
WA
Enumeration date
07/10/2006
Last updated
07/21/2022
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