Individual
COREY LEE PLASTER
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
421 W RIVERSIDE AVE, SUITE 810, SPOKANE, WA 99201-0405
(509) 747-2070
(509) 624-1485
Mailing address
421 W RIVERSIDE AVE, SUITE 810, SPOKANE, WA 99201-0405
(509) 747-2070
(509) 624-1485
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
9667
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
050613907 5571PL
ASSURIS PROVIDER #
WA
01
—
1685716
UNITED CONCORDIA #
WA
01
—
5048095
DSHS PROVIDER #
WA
01
—
86815
WDS PROVIDER #
WA
Enumeration date
12/22/2005
Last updated
07/08/2007
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