Healthcare Provider Details

I. General information

NPI: 1245359926
Provider Name (Legal Business Name): DISCOVERY DENTURE CENTER, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/27/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1700 COOPER POINT RD SW STE B3
OLYMPIA WA
98502-1110
US

IV. Provider business mailing address

1700 COOPER POINT RD SW STE B3
OLYMPIA WA
98502-1110
US

V. Phone/Fax

Practice location:
  • Phone: 360-943-6290
  • Fax: 360-943-8505
Mailing address:
  • Phone: 360-943-6290
  • Fax: 360-943-8505

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122400000X
TaxonomyDenturist
License Number
License Number State

VIII. Authorized Official

Name: JULIE STONE
Title or Position: PRESIDENT
Credential:
Phone: 360-943-6290