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General NPI Number Information
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NPI Number | 1942453964
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Entity Type | Organization
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Legal Business Name | ROBERT M. GISWOLD, DDS
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Dates
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Enumeration Date | 11/04/2008
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Last Update Date | 03/12/2013
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Provider Practice Location Address
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Address Line | 742 CAMANO AVE SUITE 101A
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City | LANGLEY
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State | WA
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Zip | 98260-9570
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Country | US
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Telephone | 360-221-6373
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Fax |
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Provider Business Mailing Address
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Address Line | 742 CAMANO AVE SUITE 101A
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City | LANGLEY
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State | WA
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Zip | 98260-9570
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | ROBERT M GISWOLD
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Credential | DDS
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Telephone | 360-221-6373
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | DE00004739
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License Number State | WA
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