Organization
EVOLUTION DENTAL ALLIANCE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOEL BLAKE DMD (CHIEF CLINICAL OFFICER)
(509) 822-2209
Entity
Organization
Contact information
Practice address
507 S WASHINGTON ST STE 190, SPOKANE, WA 99204-2608
(509) 566-0000
Mailing address
507 S WASHINGTON ST STE 40, SPOKANE, WA 99204-2604
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
02/27/2018
Last updated
02/27/2018
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