| Advanced Dental Specialists | |
|
406 Se 131st Ave Ste 305 Vancouver WA 98683-4014 | |
| (360) 253-9792 | |
| (360) 604-5266 |
| Full Name | Advanced Dental Specialists |
|---|---|
| Speciality | Dentist - Prosthodontics |
| Location | 406 Se 131st Ave Ste 305, Vancouver, Washington |
| Authorized Official Name and Position | Ellis Burke Jardine (OWNER) |
| Authorized Official Contact | 3602539792 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Advanced Dental Specialists 406 Se 131st Ave Ste 305 Vancouver WA 98683-4014 Ph: (360) 253-9792 | Advanced Dental Specialists 406 Se 131st Ave Ste 305 Vancouver WA 98683-4014 Ph: (360) 253-9792 |
| NPI Number | 1720458359 |
|---|---|
| Provider Enumeration Date | 09/24/2015 |
| Last Update Date | 03/07/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1720458359 | NPI | - | NPPES |
| WA 60339865 | Other | WA | WA DENTAL LICENSE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0700X | Dentist - Prosthodontics | 60339865 (Washington) | Primary |
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