| Periodontal Concepts | |
|
300 Se 120th Ave Ste 500 Vancouver WA 98683-4020 | |
| (360) 254-8151 | |
| (360) 254-7175 |
| Full Name | Periodontal Concepts |
|---|---|
| Speciality | Dentist - Periodontics |
| Location | 300 Se 120th Ave Ste 500, Vancouver, Washington |
| Authorized Official Name and Position | Munib Y. Derhalli (PRESIDENT) |
| Authorized Official Contact | 3602548151 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Periodontal Concepts 300 Se 120th Ave Ste 500 Vancouver WA 98683-4020 Ph: (360) 254-8151 | Periodontal Concepts 300 Se 120th Ave Ste 500 Vancouver WA 98683-4020 Ph: (360) 254-8151 |
| NPI Number | 1205041514 |
|---|---|
| Provider Enumeration Date | 05/11/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1205041514 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0300X | Dentist - Periodontics | DE7432 (Washington) | Primary |
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