| NPI | 1740630128 |
|---|---|
| Other Name | PCHS DENTAL 6TH |
| Entity Type | Organization |
| Authorized Contact | JENNIFER KREIDLER-MOSS CEO 360-377-3776 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice |
| Additional Taxonomies | 261QF0400X Clinic/Center Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2016-06-16 |
| Last Update Date | 2022-04-20 |