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405 S Granite Ave Granite Falls WA 98252-8474 | |
(918) 766-5312 | |
Not Available |
Full Name | |
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Speciality | Clinic/center - Dental |
Location | 405 S Granite Ave, Granite Falls, Washington |
Authorized Official Name and Position | David Gore (DENTIST, OWNER) |
Authorized Official Contact | 9187665312 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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405 S Granite Ave Granite Falls WA 98252-8474 Ph: (360) 691-7793 | 405 S Granite Ave Granite Falls WA 98252-8474 Ph: (918) 766-5312 |
NPI Number | 1013521400 |
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Provider Enumeration Date | 09/02/2020 |
Last Update Date | 11/11/2020 |
Identifier | Type | State | Issuer |
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1013521400 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |