| Kidsmile Dental | |
|
12615 E Mission Ave Suite 312 Spokane Valley WA 99216-1047 | |
| (509) 926-1234 | |
| (509) 926-1701 |
| Full Name | Kidsmile Dental |
|---|---|
| Speciality | Dentist - Pediatric Dentistry |
| Location | 12615 E Mission Ave, Spokane Valley, Washington |
| Authorized Official Name and Position | T. Joel Blake (OWNER/DENTIST) |
| Authorized Official Contact | 5099261234 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Kidsmile Dental 12615 E Mission Ave Suite 312 Spokane Valley WA 99216-1047 Ph: (509) 926-1234 | Kidsmile Dental 12615 E Mission Ave Suite 312 Spokane Valley WA 99216-1047 Ph: (509) 926-1234 |
| NPI Number | 1255531018 |
|---|---|
| Provider Enumeration Date | 07/20/2007 |
| Last Update Date | 03/31/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1255531018 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 10588 (Washington) | Secondary |
| 1223P0221X | Dentist - Pediatric Dentistry | 9846 (Washington) | Primary |
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