| Camas Center Dental Clinic | |
|
1821 Leclerc Rd N Ste 1 Cusick WA 99119-5015 | |
| (509) 447-7111 | |
| (509) 445-1152 |
| Full Name | Camas Center Dental Clinic |
|---|---|
| Speciality | Dentist |
| Location | 1821 Leclerc Rd N Ste 1, Cusick, Washington |
| Authorized Official Name and Position | Tracy Lynn Birdtail (AM) |
| Authorized Official Contact | 5094477112 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Camas Center Dental Clinic Po Box 67 Usk WA 99180-0067 Ph: (509) 447-7111 | Camas Center Dental Clinic 1821 Leclerc Rd N Ste 1 Cusick WA 99119-5015 Ph: (509) 447-7111 |
| NPI Number | 1083980080 |
|---|---|
| Provider Enumeration Date | 03/24/2012 |
| Last Update Date | 09/13/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1083980080 | NPI | - | NPPES |
| 5051537 | Medicaid | WA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | DE00009801 (Washington) | Primary |