| Three Rivers Dental | |
|
620 Triangle Shopping Ctr Ste 660 Longview WA 98632-4690 | |
| (360) 803-8003 | |
| Not Available |
| Full Name | Three Rivers Dental |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 620 Triangle Shopping Ctr Ste 660, Longview, Washington |
| Authorized Official Name and Position | Jared Doman (OWNER) |
| Authorized Official Contact | 3606019454 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Three Rivers Dental 633 Nw 164th St Ridgefield WA 98642-9478 | Three Rivers Dental 620 Triangle Shopping Ctr Ste 660 Longview WA 98632-4690 Ph: (360) 803-8003 |
| NPI Number | 1932805363 |
|---|---|
| Provider Enumeration Date | 02/07/2023 |
| Last Update Date | 02/07/2023 |
| Certification Date | 02/07/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1932805363 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (NU) | Primary |
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