| |
2020 9th Ave Ste A Longview WA 98632-4072 | |
(360) 423-0290 | |
(360) 423-5596 |
Full Name | |
---|---|
Speciality | Dentist - General Practice |
Location | 2020 9th Ave Ste A, Longview, Washington |
Authorized Official Name and Position | Matthew R Mckinlay (RECEIVER) |
Authorized Official Contact | 2087242257 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
2020 9th Ave Ste A Longview WA 98632-4072 Ph: (360) 423-0290 | 2020 9th Ave Ste A Longview WA 98632-4072 Ph: (360) 423-0290 |
NPI Number | 1659793396 |
---|---|
Provider Enumeration Date | 01/15/2014 |
Last Update Date | 01/15/2014 |
Identifier | Type | State | Issuer |
---|---|---|---|
1659793396 | NPI | - | NPPES |
1306993340 | Other | WA | INDIVIDUAL NPI |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
Matthew E Lesh Dmd Pc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 950 14th Ave, Longview, WA 98632 Phone: 360-200-4924 | |
Dr Azizi Pllc Dental Clinic Medicare: Medicare Enrolled Practice Location: 1538 11th Ave, Longview, WA 98632 Phone: 323-804-1324 |