| NPI | 1497455141 |
|---|---|
| Other Name | PENINSULA COMMUNITY HEALTH SERVICES- FAMILY DENTAL |
| Entity Type | Organization |
| Authorized Contact | JENNIFER LYNN KREIDLER-MOSS CEO 360-478-2366 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Additional Taxonomies | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2023-03-09 |
| Last Update Date | 2023-03-09 |