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1105 14th Ave Longview WA 98632-3016 | |
(360) 425-8140 | |
(360) 425-8145 |
Full Name | |
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Speciality | Dentist - General Practice |
Location | 1105 14th Ave, Longview, Washington |
Authorized Official Name and Position | Mark Douglas Teigen (OWNER) |
Authorized Official Contact | 3604258140 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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1105 14th Ave Longview WA 98632-3016 Ph: (360) 425-8140 | 1105 14th Ave Longview WA 98632-3016 Ph: (360) 425-8140 |
NPI Number | 1740560911 |
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Provider Enumeration Date | 08/19/2011 |
Last Update Date | 08/19/2011 |
Identifier | Type | State | Issuer |
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1740560911 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1223G0001X | Dentist - General Practice | DE7669 (Washington) | 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 |