| Fairfield Dental Clinic, Llc | |
|
214 E Main Fairfield WA 99012 | |
| (509) 283-2261 | |
| (509) 283-2261 |
| Full Name | Fairfield Dental Clinic, Llc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 214 E Main, Fairfield, Washington |
| Authorized Official Name and Position | William Marc Petersen (PRESIDENT) |
| Authorized Official Contact | 5092832261 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Fairfield Dental Clinic, Llc Po Box 305 Fairfield WA 99012-0305 Ph: (509) 283-2261 | Fairfield Dental Clinic, Llc 214 E Main Fairfield WA 99012 Ph: (509) 283-2261 |
| NPI Number | 1598975849 |
|---|---|
| Provider Enumeration Date | 05/23/2007 |
| Last Update Date | 06/23/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1598975849 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
The Fairfield Dental Clinic Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 214 Main St, Fairfield, WA 99012 Phone: 509-283-2261 |