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General NPI Number Information
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NPI Number | 1699599324
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Entity Type | Organization
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Legal Business Name | DENTURE DESIGN STUDIO, PLLC
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Dates
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Enumeration Date | 11/11/2024
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Last Update Date | 11/11/2024
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Provider Practice Location Address
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Address Line | 1298 SE 12TH ST
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City | COLLEGE PLACE
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State | WA
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Zip | 99324-9727
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Country | US
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Telephone | 509-529-1469
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Fax |
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Provider Business Mailing Address
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Address Line | 7233 W DESCHUTES AVE STE E
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City | KENNEWICK
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State | WA
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Zip | 99336-6707
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Country | US
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Telephone | 509-529-1469
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | JOSHUA DANIEL BROOKS
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Credential |
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Telephone | 509-303-9090
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122400000X
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Taxonomy Name | Denturist
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License Number |
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License Number State |
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