Organization
CASCADE ORAL & MAXILLOFACIAL SURGERY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOHN RICHARD AMES D.D.S. (PRESIDENT)
(509) 468-1535
Entity
Organization
Contact information
Practice address
101 W CASCADE WAY, SUITE 103, SPOKANE, WA 99208-6003
(590) 468-1535
(509) 467-6372
Mailing address
101 W CASCADE WAY, SUITE 103, SPOKANE, WA 99208-6003
(590) 468-1535
(509) 467-6372
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
—
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
153401
L&I
WA
05
—
5027834
—
WA
01
—
5348121280021310
UNITED CONCORDIA
WA
05
—
AB20298
—
WA
Enumeration date
10/25/2005
Last updated
08/22/2020
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