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General NPI Number Information
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NPI Number | 1487176228
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Entity Type | Organization
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Legal Business Name | WELCH VANBIBBER HAUGHT DDS PC
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Dates
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Enumeration Date | 07/13/2017
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Last Update Date | 07/13/2017
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Provider Practice Location Address
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Address Line | 1417 E FRONT ST
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City | PORT ANGELES
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State | WA
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Zip | 98362-4618
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Country | US
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Telephone | 253-759-5437
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Fax |
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Provider Business Mailing Address
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Address Line | 5401 6TH AVE STE 201
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City | TACOMA
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State | WA
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Zip | 98406-2618
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Country | US
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Telephone | 253-759-5437
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Fax | 253-426-1836
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Authorized Official
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Title or Position | REGIONAL MANAGER
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Name | CHRISTINA OJEDA
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Credential |
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Telephone | 253-347-9917
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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 | DE60282727
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License Number State | WA
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