Organization
PEDIATRIC DENTAL ANESTHESIOLOGISTS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STEPHEN CARLSON MD (PARTNER)
(509) 939-1215
Entity
Organization
Contact information
Practice address
9711 N NEVADA ST, SPOKANE, WA 99218-3412
(509) 755-5437
Mailing address
5437 S QUAIL RIDGE CIR, SPOKANE, WA 99223-6390
(509) 939-1215
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
—
—
Other
Enumeration date
07/22/2020
Last updated
07/22/2020
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