# STUART DENTAL LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Blue Mountain Dental Care
- **Organization subpart:** No

## Provider details

- **NPI number:** 1023379633
- **Authorized official:** MARCY BOLSTER (OFFICE COORDINATOR)
- **Authorized official phone:** (509) 525-4662

## Contact information

- **Practice address:** 1545 BUSINESS ONE CIR, WALLA WALLA, WA 99362-9526
- **Practice address phone:** (509) 525-4662
- **Practice address fax:** (509) 525-0513
- **Mailing address:** 1545 BUSINESS ONE CIR, WALLA WALLA, WA 99362-9526
- **Mailing address phone:** (509) 525-4662
- **Mailing address fax:** (509) 525-0513

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | 9646 | WA | Yes |

## Other

- **Enumeration date:** 05/31/2012
- **Last updated:** 05/31/2012