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140 Gage Blvd Ste 200 Richland WA 99352-8916 | |
| (509) 542-9111 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 140 Gage Blvd Ste 200, Richland, Washington |
| Authorized Official Name and Position | Robert M Gottlieb (OWNER) |
| Authorized Official Contact | 4254869111 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
5723 Ne Bothell Way Ste C Kenmore WA 98028-9404 Ph: (425) 486-9111 | 140 Gage Blvd Ste 200 Richland WA 99352-8916 Ph: (509) 542-9111 |
| NPI Number | 1861814980 |
|---|---|
| Provider Enumeration Date | 01/08/2014 |
| Last Update Date | 01/08/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1861814980 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (Washington) | Primary |
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