Kids Dental Of Centralia, P.c. | |
1611 Kresky Ave Centralia WA 98531-8982 | |
(360) 736-5437 | |
Not Available |
Full Name | Kids Dental Of Centralia, P.c. |
---|---|
Speciality | Dentist - General Practice |
Location | 1611 Kresky Ave, Centralia, Washington |
Authorized Official Name and Position | Justin Vanbibber (OWNER) |
Authorized Official Contact | 3607365437 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Kids Dental Of Centralia, P.c. 1611 Kresky Ave Centralia WA 98531-8982 Ph: () - | Kids Dental Of Centralia, P.c. 1611 Kresky Ave Centralia WA 98531-8982 Ph: (360) 736-5437 |
NPI Number | 1659796076 |
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Provider Enumeration Date | 02/21/2014 |
Last Update Date | 02/21/2014 |
Identifier | Type | State | Issuer |
---|---|---|---|
1659796076 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1223G0001X | Dentist - General Practice | DE60282727 (Washington) | Primary |
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