Provider Demographics
NPI:1609697119
Name:CENTER FOR DENTAL WELLNESS, PLLC
Entity type:Organization
Organization Name:CENTER FOR DENTAL WELLNESS, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TAYLOR
Authorized Official - Middle Name:
Authorized Official - Last Name:ZOLLINGER
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:218-443-1811
Mailing Address - Street 1:15805 E 23RD AVE
Mailing Address - Street 2:
Mailing Address - City:SPOKANE VALLEY
Mailing Address - State:WA
Mailing Address - Zip Code:99037-9042
Mailing Address - Country:US
Mailing Address - Phone:218-443-1811
Mailing Address - Fax:
Practice Address - Street 1:1700 E SCHNEIDMILLER AVE
Practice Address - Street 2:
Practice Address - City:POST FALLS
Practice Address - State:ID
Practice Address - Zip Code:83854-7085
Practice Address - Country:US
Practice Address - Phone:218-443-1811
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-10-18
Last Update Date:2024-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental