| Kids Dental Of Centralia, P.c. | |
|
1611 Kresky Ave Centralia WA 98531-8982 | |
| (360) 736-5437 | |
| Not Available |
| Full Name | Kids Dental Of Centralia, P.c. |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 1611 Kresky Ave, Centralia, Washington |
| Authorized Official Name and Position | Justin Vanbibber (OWNER) |
| Authorized Official Contact | 3607365437 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Kids Dental Of Centralia, P.c. 1611 Kresky Ave Centralia WA 98531-8982 Ph: () - | Kids Dental Of Centralia, P.c. 1611 Kresky Ave Centralia WA 98531-8982 Ph: (360) 736-5437 |
| NPI Number | 1659796076 |
|---|---|
| Provider Enumeration Date | 02/21/2014 |
| Last Update Date | 02/21/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1659796076 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | DE60282727 (Washington) | Primary |
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