| Lower Columbia Oral Health | |
|
1538 11th Ave Longview WA 98632-4123 | |
| (360) 636-3400 | |
| (360) 578-1277 |
| Full Name | Lower Columbia Oral Health |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 1538 11th Ave, Longview, Washington |
| Authorized Official Name and Position | Daniel Scott Haghighi (OWNER) |
| Authorized Official Contact | 3606363400 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Lower Columbia Oral Health 1538 11th Ave Longview WA 98632-4123 Ph: (360) 636-3400 | Lower Columbia Oral Health 1538 11th Ave Longview WA 98632-4123 Ph: (360) 636-3400 |
| NPI Number | 1477508794 |
|---|---|
| Provider Enumeration Date | 05/24/2006 |
| Last Update Date | 06/13/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1477508794 | NPI | - | NPPES |
| 001004 | Medicaid | OR | |
| 5021076 | Medicaid | WA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 7443 (Washington) | Primary |
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