| East Fork Dental Llc | |
|
15 Sw 20th Ave Battle Ground WA 98604-3133 | |
| (360) 687-5665 | |
| Not Available |
| Full Name | East Fork Dental Llc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 15 Sw 20th Ave, Battle Ground, Washington |
| Authorized Official Name and Position | Karl Rose (OWNER) |
| Authorized Official Contact | 3606876556 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| East Fork Dental Llc Po Box 157 Battle Ground WA 98604-0157 Ph: () - | East Fork Dental Llc 15 Sw 20th Ave Battle Ground WA 98604-3133 Ph: (360) 687-5665 |
| NPI Number | 1578034526 |
|---|---|
| Provider Enumeration Date | 12/16/2018 |
| Last Update Date | 12/16/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1578034526 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
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