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General NPI Number Information
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NPI Number | 1942119631
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Entity Type | Organization
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Legal Business Name | GOOD FIT DENTURE LLC
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Dates
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Enumeration Date | 09/07/2026
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Last Update Date | 09/07/2026
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Provider Practice Location Address
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Address Line | 516 SE CHKALOV DR STE 47
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City | VANCOUVER
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State | WA
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Zip | 98683-5278
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Country | US
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Telephone | 360-216-6258
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Fax |
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Provider Business Mailing Address
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Address Line | 14820 NE 74TH CIR
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City | VANCOUVER
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State | WA
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Zip | 98682-5097
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Country | US
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Telephone | 360-216-6258
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Fax |
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Authorized Official
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Title or Position | DENTURIST360
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Name | MIN-U TAN
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Credential | LD
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Telephone | 360-281-5388
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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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