| Volunteers In Medicine Of The Olympics Dental | |
|
819 Georgiana St Port Angeles WA 98362-3511 | |
| (360) 457-4431 | |
| (360) 457-7755 |
| Full Name | Volunteers In Medicine Of The Olympics Dental |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 819 Georgiana St, Port Angeles, Washington |
| Authorized Official Name and Position | Mary E Hogan (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 3604574431 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Volunteers In Medicine Of The Olympics Dental Po Box 639 Port Angeles WA 98362-0114 Ph: (360) 457-4431 | Volunteers In Medicine Of The Olympics Dental 819 Georgiana St Port Angeles WA 98362-3511 Ph: (360) 457-4431 |
| NPI Number | 1881130912 |
|---|---|
| Provider Enumeration Date | 01/12/2017 |
| Last Update Date | 01/12/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1881130912 | NPI | - | NPPES |
| 2031476 | Medicaid | WA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 602166835 (Washington) | Primary |
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