Healthcare Provider Details

I. General information

NPI: 1932217403
Provider Name (Legal Business Name): DAVID WILLIAM DORMANS D.D.S., M.S.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/26/2006
Last Update Date: 02/04/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6803 BIG CEDAR LN
ANACORTES WA
98221-8304
US

IV. Provider business mailing address

PO BOX 486
ANACORTES WA
98221-0486
US

V. Phone/Fax

Practice location:
  • Phone: 360-299-0404
  • Fax: 360-299-0606
Mailing address:
  • Phone: 360-299-0404
  • Fax: 360-299-0606

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code122300000X
TaxonomyDentist
License NumberDE00008184
License Number StateWA
# 2
Primary TaxonomyY
Taxonomy Code1223D0004X
TaxonomyDental Anesthesiology
License NumberDE00008184
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: