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950 14th Ave Longview WA 98632-2317 | |
| (360) 200-4924 | |
| (360) 200-4923 |
| Full Name | |
|---|---|
| Speciality | Dentist |
| Location | 950 14th Ave, Longview, Washington |
| Authorized Official Name and Position | William Kalob Lesh (OWNER) |
| Authorized Official Contact | 3602004924 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
950 14th Ave. Longview WA 98632 Ph: (360) 200-4924 | 950 14th Ave Longview WA 98632-2317 Ph: (360) 200-4924 |
| NPI Number | 1205173457 |
|---|---|
| Provider Enumeration Date | 01/08/2013 |
| Last Update Date | 07/21/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1205173457 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | DE00007934 (Washington) | Secondary |
| 122300000X | Dentist | 60769596 (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 |