Organization
FREUEN HAUCK PAXTON OMS PLLC
Active
Organization
FREUEN HAUCK PAXTON OMS PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. RENEE KRISTEN BANCROFT (ADMIN MANAGER)
(509) 242-3336
Entity
Organization
Contact information
Practice address
9911 N NEVADA ST STE 120, SPOKANE, WA 99218-1298
(509) 242-3336
Mailing address
9911 N NEVADA ST STE 120, SPOKANE, WA 99218-1298
(509) 242-3336
(866) 554-1392
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
—
WA
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
60378265
WASHINGTON STATE LICENSE
WA
01
—
8645
WASHINGTON STATE LICENSE
WA
Enumeration date
10/02/2017
Last updated
04/04/2019
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