MEDICARE: KRISTINE AADLAND 2 DMD PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QD0000X	Dental Clinic/Center

General Provider Information

NPI Number	:	1932680675
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	KRISTINE AADLAND 2 DMD PLLC

Provider Business Mailing Address
First Line	:	117 E 39TH ST
Second Line	:
City	:	VANCOUVER
State	:	WA
Zip	:	98663-2229
Country	:	US
Telephone Number	:	360-694-7931
Fax Number	:

Provider Business Practice Location Address
First Line	:	117 E 39TH ST
Second Line	:
City	:	VANCOUVER
State	:	WA
Zip	:	98663-2229
Country	:	US
Telephone Number	:	360-694-7931
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DR. KRISTINE AADLAND
Credential	:	DMD
Telephone Number	:	360-573-6047

Provider Enumeration Date	:	08/21/2018
Last Update Date	:	08/21/2018

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