Jonathan M. Fairbanks, D.d.s., Pllc
NPI #1144546102 in Pullman, Washington
Provider Information
- NPI Number
- 1144546102
- Entity Type
- Organization
- Organization Name
- Jonathan M. Fairbanks, D.d.s., Pllc
- Primary Specialty
- Dentist - General Practice
- Enumeration Date
- Apr 15, 2010
- Last Updated
- Mar 16, 2012
Practice Location
- Address
- 1410 SE BISHOP BLVD # 1S
- City
- Pullman
- State
- Washington
- ZIP Code
- 99163-5419
- Phone
- (509) 334-6700
Authorized Official
- Name
- DR. JONATHAN MARVIN FAIRBANKS, DDS
- Title
- DENTIST
- Phone
- (509) 332-7463
Specialties & Taxonomy Codes
| Specialty |
|---|
| Dentist - General Practice — General Practice |
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