Provider Demographics
NPI:1699519991
Name:NYGAARD POOVEY, PLLC
Entity type:Organization
Organization Name:NYGAARD POOVEY, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JONATHAN
Authorized Official - Middle Name:
Authorized Official - Last Name:AMMON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:509-927-3272
Mailing Address - Street 1:1005 N EVERGREEN RD STE 102
Mailing Address - Street 2:
Mailing Address - City:SPOKANE VALLEY
Mailing Address - State:WA
Mailing Address - Zip Code:99216-1485
Mailing Address - Country:US
Mailing Address - Phone:509-927-3272
Mailing Address - Fax:509-926-4320
Practice Address - Street 1:1005 N EVERGREEN RD STE 102
Practice Address - Street 2:
Practice Address - City:SPOKANE VALLEY
Practice Address - State:WA
Practice Address - Zip Code:99216-1485
Practice Address - Country:US
Practice Address - Phone:509-927-3272
Practice Address - Fax:509-926-4320
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-06-21
Last Update Date:2024-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0300XDental ProvidersDentistPeriodonticsGroup - Single Specialty