| Walberto Cantu Dds Pllc | |
|
4001 Kennedy Rd Ste 1 West Richland WA 99353-7353 | |
| (509) 980-0155 | |
| Not Available |
| Full Name | Walberto Cantu Dds Pllc |
|---|---|
| Speciality | Dentist |
| Location | 4001 Kennedy Rd Ste 1, West Richland, Washington |
| Authorized Official Name and Position | Walberto Cantu (CEO) |
| Authorized Official Contact | 5099800155 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Walberto Cantu Dds Pllc 4001 Kennedy Rd Ste 1 West Richland WA 99353-7353 Ph: (509) 980-0155 | Walberto Cantu Dds Pllc 4001 Kennedy Rd Ste 1 West Richland WA 99353-7353 Ph: (509) 980-0155 |
| NPI Number | 1508457110 |
|---|---|
| Provider Enumeration Date | 01/27/2021 |
| Last Update Date | 01/27/2021 |
| Medicare PECOS PAC ID | 0648685586 |
|---|---|
| Medicare Enrollment ID | O20210226000963 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1508457110 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
| Provider Name | Walberto Cantu |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1346667292 PECOS PAC ID: 8527365311 Enrollment ID: I20210226001064 |
Penttila Schroeder Maxfield,dds, Ps Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 4476 W Van Giesen St, West Richland, WA 99353 Phone: 509-967-3421 Fax: 509-967-2186 |