| Distinctive Dental Care | |
|
601 Se 117th Ave Suite 230 Vancouver WA 98683-5297 | |
| (360) 892-1170 | |
| (360) 604-1172 |
| Full Name | Distinctive Dental Care |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 601 Se 117th Ave, Vancouver, Washington |
| Authorized Official Name and Position | Daniel E Wilson (MEMBER OF PLLC) |
| Authorized Official Contact | 3608921170 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Distinctive Dental Care 601 Se 117th Ave Suite 230 Vancouver WA 98683-5297 Ph: (360) 892-1170 | Distinctive Dental Care 601 Se 117th Ave Suite 230 Vancouver WA 98683-5297 Ph: (360) 892-1170 |
| NPI Number | 1023323144 |
|---|---|
| Provider Enumeration Date | 08/12/2010 |
| Last Update Date | 11/15/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1023323144 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 00009284 (Washington) | Secondary |
| 1223G0001X | Dentist - General Practice | 00004959 (Washington) | Primary |
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