| Meyers-folsom Dental Clinic | |
|
1336 5th St Clarkston WA 99403-3314 | |
| (509) 758-5011 | |
| (509) 751-9125 |
| Full Name | Meyers-folsom Dental Clinic |
|---|---|
| Speciality | Dentist |
| Location | 1336 5th St, Clarkston, Washington |
| Authorized Official Name and Position | Cari E Meyers (AUTHORIZED OFFICIAL) |
| Authorized Official Contact | 5097585011 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Meyers-folsom Dental Clinic 1336 5th St Clarkston WA 99403-3314 Ph: (509) 758-5011 | Meyers-folsom Dental Clinic 1336 5th St Clarkston WA 99403-3314 Ph: (509) 758-5011 |
| NPI Number | 1740434125 |
|---|---|
| Provider Enumeration Date | 11/11/2008 |
| Last Update Date | 06/12/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1740434125 | NPI | - | NPPES |
| 5007018 | Medicaid | WA | |
| 5021787 | Medicaid | WA | |
| DE00007440 | Other | WA | STATE LICENSE NUMBER |
| DE60882146 | Other | WA | STATE LICENSE NUMBER |
| DE00005292 | Other | WA | STATE LICENSE NUMBER |
| 5000146 | Medicaid | WA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | DE00005292 (Washington) | Primary |
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