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General NPI Number Information
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NPI Number | 1194683854
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Entity Type | Organization
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Legal Business Name | DUNIVIN DENTURE LLC
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Dates
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Enumeration Date | 01/12/2026
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Last Update Date | 01/12/2026
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Provider Practice Location Address
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Address Line | 1000 12TH AVE
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City | LONGVIEW
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State | WA
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Zip | 98632-2500
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Country | US
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Telephone | 360-232-8756
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Fax |
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Provider Business Mailing Address
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Address Line | 1000 12TH AVE
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City | LONGVIEW
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State | WA
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Zip | 98632-2500
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Country | US
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Telephone | 360-232-8756
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Fax |
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Authorized Official
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Title or Position | DENTURIST / MEMBER
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Name | CODY MARSHALL DUNIVIN
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Credential | LD
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Telephone | 360-232-8756
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State |
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