| Port Gamble S'klallam Dental Clinic | |
|
32014 Little Boston Rd Ne Kingston WA 98346-9734 | |
| (360) 297-9601 | |
| (360) 297-9614 |
| Full Name | Port Gamble S'klallam Dental Clinic |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 32014 Little Boston Rd Ne, Kingston, Washington |
| Authorized Official Name and Position | Kerstin Margareta Powell (HEALTH CENTER BUSINESS OFFICE MANAG) |
| Authorized Official Contact | 3602979601 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Port Gamble S'klallam Dental Clinic 32014 Little Boston Rd Ne Kingston WA 98346-9734 Ph: (360) 297-9601 | Port Gamble S'klallam Dental Clinic 32014 Little Boston Rd Ne Kingston WA 98346-9734 Ph: (360) 297-9601 |
| NPI Number | 1669531067 |
|---|---|
| Provider Enumeration Date | 12/08/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1669531067 | NPI | - | NPPES |
| 5031810 | Medicaid | WA | |
| 5031794 | Medicaid | WA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
Kingston Dental Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 25985 Barber Cut Off Rd Ne, Suite B2, Kingston, WA 98346 Phone: 360-297-2298 Fax: 360-297-8445 | |
Appletree Cove Dental Center Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 26114 Illinois Ave Ne, Kingston, WA 98346 Phone: 360-297-3392 |