MEDICARE: EVERSON DENTAL CLINIA

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	261QD0000X	Dental Clinic/Center

General Provider Information

NPI Number	:	1720086473
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EVERSON DENTAL CLINIA

Provider Business Mailing Address
First Line	:	PO BOX 387
Second Line	:
City	:	EVERSON
State	:	WA
Zip	:	98247-0387
Country	:	US
Telephone Number	:	360-966-7777
Fax Number	:	360-966-4510

Provider Business Practice Location Address
First Line	:	201 E MAIN ST
Second Line	:
City	:	EVERSON
State	:	WA
Zip	:	98247-9126
Country	:	US
Telephone Number	:	360-966-7777
Fax Number	:

Authorized Official
Title or Position	:	DENTIST
Name	:	DR. DANIEL T BARRETT
Credential	:	DDS
Telephone Number	:	360-966-7777

Provider Enumeration Date	:	07/07/2005
Last Update Date	:	08/22/2020

Similar Medicare Providers

1750498069 — DR. DANIEL T BARRETT DDS
Practice Location Address:

201 E MAIN ST
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98247-9126

Practice Phone: 360-966-7777
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1568651057 — MEAGAN KAMMENGA PHARMD
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1528472925 — MICHAEL DAVID BARRETT DMD
Practice Location Address:

201 E MAIN ST
EVERSON, WA
98247-9126

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Practice Fax: 360-966-4510

1700466356 — NOOKSACK VALLEY DRUG STORE LLC
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1790782209 — JONATHAN W GRYMALOSKI M.D.
Practice Location Address:

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Directions to “EVERSON DENTAL CLINIA ” Practice Location

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