| Cascade Dental | |
|
16703 Se Mcgillivray Blvd Ste 100 Vancouver WA 98683-3418 | |
| (360) 892-2994 | |
| (360) 892-3929 |
| Full Name | Cascade Dental |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 16703 Se Mcgillivray Blvd Ste 100, Vancouver, Washington |
| Authorized Official Name and Position | Daniel Edwin Wilson (PRESIDENT/OWNER) |
| Authorized Official Contact | 3603148723 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Cascade Dental 16703 Se Mcgillivray Blvd Ste 100 Vancouver WA 98683-3418 Ph: (360) 892-2994 | Cascade Dental 16703 Se Mcgillivray Blvd Ste 100 Vancouver WA 98683-3418 Ph: (360) 892-2994 |
| NPI Number | 1669973160 |
|---|---|
| Provider Enumeration Date | 02/21/2018 |
| Last Update Date | 02/21/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1669973160 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | DE00009284 (Washington) | Primary |
| 1223G0001X | Dentist - General Practice | D7955 (Oregon) | Secondary |
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