Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 122400000X | Denturist | DN60035947 | WA |
NPI | 1154572410 |
---|---|
Provider Name | Mr. Richard K Mcmillen |
First Address | Spokane, WA 99223-3832 |
Second Address | Spokane, WA 99223-3832 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 06/10/2008 |
Last Update Date | 06/10/2008 |