| Aspen Dental | |
|
740 Ocean Beach Hwy Ste F Longview WA 98632-4061 | |
| (360) 414-1400 | |
| (360) 414-5223 |
| Full Name | Aspen Dental |
|---|---|
| Speciality | Dentist |
| Location | 740 Ocean Beach Hwy Ste F, Longview, Washington |
| Authorized Official Name and Position | Kala Madugula (OWNER) |
| Authorized Official Contact | 3154546000 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Aspen Dental Po Box 3189 Syracuse NY 13220-3189 Ph: (315) 454-6000 | Aspen Dental 740 Ocean Beach Hwy Ste F Longview WA 98632-4061 Ph: (360) 414-1400 |
| NPI Number | 1285978189 |
|---|---|
| Provider Enumeration Date | 11/15/2012 |
| Last Update Date | 11/15/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1285978189 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 272750 (Washington) | Primary |
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