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2020 9th Ave Ste A Longview WA 98632-4072 | |
| (503) 840-8925 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 2020 9th Ave Ste A, Longview, Washington |
| Authorized Official Name and Position | Julia Gourley (OWNER/DENTIST) |
| Authorized Official Contact | 5038408925 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
2020 9th Ave Ste A Longview WA 98632-4072 Ph: (503) 840-8925 | 2020 9th Ave Ste A Longview WA 98632-4072 Ph: (503) 840-8925 |
| NPI Number | 1407244221 |
|---|---|
| Provider Enumeration Date | 12/31/2014 |
| Last Update Date | 12/31/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1407244221 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | DE60299927 (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 |