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Organization

BANICH FAMILY DENTAL

Active
Other names
Steven G. Banich DDS PLLC
Organization subpart
No

Provider details

NPI number
Authorized official
MISS JULIE ANN MACE (OFFICE MANAGER)
(509) 684-4586
Entity
Organization

Contact information

Practice address
775 S MAIN ST, STE C, COLVILLE, WA 99114-2514
(509) 684-4586
(509) 685-1043
Mailing address
775 S MAIN ST, STE C, COLVILLE, WA 99114-2514
(509) 684-4586
(509) 685-1043

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
606128-00-5
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
5513106
WA
Enumeration date
09/22/2010
Last updated
09/22/2010
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