MEDICARE: DR. JOSEPH FLAHERTY CHURCHILL D.D.S.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	122300000X	Dentist	DE60821138	WA

General Provider Information

NPI Number	:	1649581653
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOSEPH FLAHERTY CHURCHILL D.D.S.

Provider Business Mailing Address
First Line	:	LOWER ELWHA DENTAL CLINIC
Second Line	:	243511 US 101
City	:	PORT ANGELES
State	:	WA
Zip	:	98363
Country	:	US
Telephone Number	:	360-452-6252
Fax Number	:	360-797-1369

Provider Business Practice Location Address
First Line	:	LOWER ELWHA DENTAL CLINIC
Second Line	:	243511 US 101
City	:	PORT ANGELES
State	:	WA
Zip	:	98363
Country	:	US
Telephone Number	:	360-452-6252
Fax Number	:	360-797-1369

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/24/2010
Last Update Date	:	12/18/2025

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