Provider Demographics
NPI:1861927675
Name:MORIN, DEVIN (DMD)
Entity type:Individual
Prefix:DR
First Name:DEVIN
Middle Name:
Last Name:MORIN
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1110 E SILVER PINE RD
Mailing Address - Street 2:
Mailing Address - City:COLBERT
Mailing Address - State:WA
Mailing Address - Zip Code:99005-5125
Mailing Address - Country:US
Mailing Address - Phone:502-712-9561
Mailing Address - Fax:
Practice Address - Street 1:6501 N CEDAR RD BLDG 2
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99208-4571
Practice Address - Country:US
Practice Address - Phone:509-312-3200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-04-30
Last Update Date:2021-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE609766451223P0221X
390200000X
IDD-5073-PD1223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program