| L. Blaine Kennington, Dds, Pc | |
|
358 Front Ave Nw Castle Rock WA 98611-8996 | |
| (360) 274-9100 | |
| (360) 274-8152 |
| Full Name | L. Blaine Kennington, Dds, Pc |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 358 Front Ave Nw, Castle Rock, Washington |
| Authorized Official Name and Position | Lester B Kennington (PRESIDENT) |
| Authorized Official Contact | 3602479100 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| L. Blaine Kennington, Dds, Pc 358 Front Ave Nw Castle Rock WA 98611-8996 Ph: (360) 274-9100 | L. Blaine Kennington, Dds, Pc 358 Front Ave Nw Castle Rock WA 98611-8996 Ph: (360) 274-9100 |
| NPI Number | 1306187836 |
|---|---|
| Provider Enumeration Date | 03/07/2013 |
| Last Update Date | 03/07/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1306187836 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | DE00009274 (Washington) | Primary |
Lily B And Samuel D Crocco Dmd Pllc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 358 Front Ave Nw, Castle Rock, WA 98611 Phone: 760-750-0087 |