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General NPI Number Information
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NPI Number | 1932987906
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Entity Type | Organization
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Legal Business Name | WASHINGTON DENTAL CORPORATION, PC
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Dates
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Enumeration Date | 09/20/2023
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Last Update Date | 09/20/2023
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Provider Practice Location Address
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Address Line | 1309 COOPER POINT RD SW STE 100
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City | OLYMPIA
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State | WA
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Zip | 98502-5514
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Country | US
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Telephone | 360-483-4765
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Fax | 360-512-3849
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Provider Business Mailing Address
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Address Line | PO BOX 920050
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City | DALLAS
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State | TX
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Zip | 75392-0050
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Country | US
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Telephone | 714-845-8890
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | CHRISTINA DONNELLY
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Credential | DMD
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Telephone | 360-483-4765
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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