is a Dental in Ellensburg, Washington. practices all healthcare services and medical treatments related to Dental. The NPI Number for is 1205046141. The last update date is .
's current location address is 521 E Mountain View Ave, Ellensburg, Washington. You can contact this provider via phone number 5099621414 and fax number 5099621408. The mailing address for is 521 E Mountain View Ave, Ellensburg, Washington. To know further, please read the information below!
Provider Profile Detail
| Provider Name | |
|---|---|
| Address | 521 E Mountain View Ave, Ellensburg, Washington |
| Phone Number | 5099621414 |
| Fax Number | 5099621408 |
| Sole Proprietor | -- |
| Credentials | -- |
NPI Number Detail
| NPI Number | 1205046141 |
|---|---|
| Provider Enumeration Date | |
| Last Updated Date |
Provider Mailing Address Detail
| Address | 521 E Mountain View Ave |
|---|---|
| City | Ellensburg |
| State | Washington (WA) |
| Post Code | 989263865 |
| Phone Number | 5099621414 |
| Fax Number | 5099621408 |
Provider's Primary Taxonomy Detail
| Speciality | Dental |
|---|---|
| Taxonomy | 261Qd0000X |
|
Definition: Provides general and specialized dental care and oral surgery. |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 7118276 | WA | -- | |
| 31820 | WA | LABOR AND INDUSTRIES |
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