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General NPI Number Information
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NPI Number | 1639305253
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Entity Type | Organization
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Legal Business Name | JOEL P. GARDNER, DMD, PS
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Dates
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Enumeration Date | 06/10/2009
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Last Update Date | 03/20/2026
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Provider Practice Location Address
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Address Line | 7204 267TH ST NW STE 103
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City | STANWOOD
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State | WA
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Zip | 98292-6271
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Country | US
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Telephone | 360-336-5464
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Fax | 360-336-3806
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Provider Business Mailing Address
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Address Line | 7204 267TH ST NW STE 103
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City | STANWOOD
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State | WA
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Zip | 98292-6271
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Country | US
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Telephone | 360-336-5464
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Fax | 360-336-3806
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Authorized Official
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Title or Position | CEO
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Name | DR. JOEL PATRICK GARDNER
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Credential |
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Telephone | 360-336-5464
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | DE00008421
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License Number State | WA
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