| Excel Dental | |
|
1401 Nw 1st St Ste 120 Battle Ground WA 98604-4540 | |
| (360) 666-5700 | |
| (360) 666-5701 |
| Full Name | Excel Dental |
|---|---|
| Speciality | Dentist |
| Location | 1401 Nw 1st St Ste 120, Battle Ground, Washington |
| Authorized Official Name and Position | Ellis Burke Jardine (OWNER) |
| Authorized Official Contact | 4808623185 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Excel Dental 1401 Nw 1st St Ste 120 Battle Ground WA 98604-4540 Ph: (360) 666-5700 | Excel Dental 1401 Nw 1st St Ste 120 Battle Ground WA 98604-4540 Ph: (360) 666-5700 |
| NPI Number | 1831558907 |
|---|---|
| Provider Enumeration Date | 02/18/2016 |
| Last Update Date | 02/18/2016 |
| Medicare PECOS PAC ID | 1456742048 |
|---|---|
| Medicare Enrollment ID | O20211215000462 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1831558907 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0700X | Dentist - Prosthodontics | DE 60339865 (Washington) | Primary |
| Provider Name | Ellis Burke Jardine |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1922205715 PECOS PAC ID: 2365833951 Enrollment ID: I20211215000523 |
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