Quileute Dental Clinic | |
560 Quileute Heights Loop La Push WA 98350 | |
(360) 374-3358 | |
Not Available |
Full Name | Quileute Dental Clinic |
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Speciality | Dentist - General Practice |
Location | 560 Quileute Heights Loop, La Push, Washington |
Authorized Official Name and Position | Gary Bryan Goodwin (BILLING AGENCY) |
Authorized Official Contact | 3608670709 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Quileute Dental Clinic Po Box 189 La Push WA 98350-0189 Ph: (360) 374-3358 | Quileute Dental Clinic 560 Quileute Heights Loop La Push WA 98350 Ph: (360) 374-3358 |
NPI Number | 1518425511 |
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Provider Enumeration Date | 03/08/2019 |
Last Update Date | 03/11/2019 |
Identifier | Type | State | Issuer |
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1518425511 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
261QD0000X | Clinic/center - Dental | (* (Not Available)) | Secondary |