| Pleasant Valley Pediatric Dentistry | |
|
14201 Ne 20th Ave Suite 3102 Vancouver WA 98686-6410 | |
| (360) 573-3176 | |
| (360) 571-3276 |
| Full Name | Pleasant Valley Pediatric Dentistry |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 14201 Ne 20th Ave, Vancouver, Washington |
| Authorized Official Name and Position | Kurt Truong (OWNER) |
| Authorized Official Contact | 3605733176 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Pleasant Valley Pediatric Dentistry 14201 Ne 20th Ave Suite 3102 Vancouver WA 98686-6410 Ph: (360) 573-3176 | Pleasant Valley Pediatric Dentistry 14201 Ne 20th Ave Suite 3102 Vancouver WA 98686-6410 Ph: (360) 573-3176 |
| NPI Number | 1093268161 |
|---|---|
| Provider Enumeration Date | 07/25/2016 |
| Last Update Date | 07/25/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1093268161 | NPI | - | NPPES |
| 2049798 | Medicaid | WA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | DE60299879 (Washington) | Primary |
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