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General NPI Number Information
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NPI Number | 1205090024
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Entity Type | Individual
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Provider Name | CHRISTINE A WOODWARD D.D.S.
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Gender | Female
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Dates
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Enumeration Date | 07/10/2008
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Last Update Date | 11/25/2020
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Provider Practice Location Address
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Address Line | 45860 MAIN ST
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City | CONCRETE
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State | WA
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Zip | 98237
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Country | US
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Telephone | 360-399-1250
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Fax | 360-404-3828
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Provider Business Mailing Address
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Address Line | PO BOX 570
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City | CONCRETE
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State | WA
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Zip | 98237-0570
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Country | US
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Telephone | 360-399-1250
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 60514482
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License Number State | WA
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Taxonomy #2
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 6291-15
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License Number State | WI
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