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General NPI Number Information
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NPI Number | 1912688854
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Entity Type | Organization
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Legal Business Name | CENTRAL DENTURES LLC
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Dates
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Enumeration Date | 07/25/2023
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Last Update Date | 02/02/2025
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Provider Practice Location Address
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Address Line | 309 E 2ND AVE
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City | ELLENSBURG
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State | WA
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Zip | 98926-3315
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Country | US
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Telephone | 509-201-1051
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 766
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City | ELLENSBURG
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State | WA
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Zip | 98926-1921
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Country | US
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Telephone | 509-962-4518
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MICHELLE LYNN MELTON
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Credential |
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Telephone | 509-962-4518
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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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Taxonomy #2
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number |
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License Number State |
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