| Cowlitz Periodontal Care & Implant Surgary | |
|
1703 Hudson St Longview WA 98632-2912 | |
| (360) 423-8000 | |
| Not Available |
| Full Name | Cowlitz Periodontal Care & Implant Surgary |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 1703 Hudson St, Longview, Washington |
| Authorized Official Name and Position | Donald G Echols (OWNER) |
| Authorized Official Contact | 3604238000 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Cowlitz Periodontal Care & Implant Surgary 1703 Hudson St Longview WA 98632-2912 Ph: (360) 423-8000 | Cowlitz Periodontal Care & Implant Surgary 1703 Hudson St Longview WA 98632-2912 Ph: (360) 423-8000 |
| NPI Number | 1205176864 |
|---|---|
| Provider Enumeration Date | 02/19/2013 |
| Last Update Date | 02/19/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1205176864 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | 6463 (Washington) | Primary |
| 261QS0112X | Clinic/center - Oral And Maxillofacial Surgery | 6463 (Washington) | Secondary |
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