| NPI | 1477630507 |
|---|---|
| Doing Business As | JAMESTOWN DENTAL CLINIC |
| Entity Type | Organization |
| Authorized Contact | W. RON ALLEN Tribal Chairman/Executive Director 360-683-1109 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist |
| Additional Taxonomies | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| 261QP0904X Clinic/Center, Public Health, Federal | |
| Enumeration Date | 2006-11-01 |
| Last Update Date | 2021-12-29 |