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2011 Mottman Rd Olympia WA 98512-6292 | |
| (360) 596-5295 | |
| (360) 596-5707 |
| Full Name | |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 2011 Mottman Rd, Olympia, Washington |
| Authorized Official Name and Position | Nancy L Mckinney (VP FOR ADMIN SVCS) |
| Authorized Official Contact | 3605965268 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
2011 Mottman Rd Olympia WA 98512-6292 Ph: (360) 596-5295 | 2011 Mottman Rd Olympia WA 98512-6292 Ph: (360) 596-5295 |
| NPI Number | 1104951565 |
|---|---|
| Provider Enumeration Date | 02/23/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1104951565 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
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