| NPI | 1295928752 |
|---|---|
| Former Legal Business Name | COLUMBIA BASIN DENTURE CARE |
| Entity Type | Organization |
| Authorized Contact | JOSHUA DANIEL BROOKS Sole Member 509-586-4350 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122400000X Denturist (Licence: WA DN00000391) |
| Additional Taxonomies | 122300000X Dentist |
| 1223G0001X Dentist, General Practice | |
| 124Q00000X Dental Hygienist | |
| 126800000X Dental Assistant | |
| 126900000X Dental Laboratory Technician | |
| Enumeration Date | 2007-08-19 |
| Last Update Date | 2020-08-24 |