| Two Rivers Dentistry | |
|
2415 Se 165th Ave Ste 102 Vancouver WA 98683-4324 | |
| (360) 256-1202 | |
| (360) 885-3580 |
| Full Name | Two Rivers Dentistry |
|---|---|
| Speciality | Dentist |
| Location | 2415 Se 165th Ave Ste 102, Vancouver, Washington |
| Authorized Official Name and Position | Vaughn Wallace Teuscher (OWNER) |
| Authorized Official Contact | 3602561202 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Two Rivers Dentistry 2415 Se 165th Ave Ste 102 Vancouver WA 98683-4324 Ph: (360) 256-1202 | Two Rivers Dentistry 2415 Se 165th Ave Ste 102 Vancouver WA 98683-4324 Ph: (360) 256-1202 |
| NPI Number | 1326491895 |
|---|---|
| Provider Enumeration Date | 07/19/2016 |
| Last Update Date | 07/19/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1326491895 | NPI | - | NPPES |
| 1104821289 | Medicaid | WA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | DE00006502 (Washington) | Primary |
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