# SWINOMISH/UPPER SKAGIT DENTAL CLINIC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1104093731
- **Authorized official:** DR. RAYMOND A DAILEY DDS (DENTIST)
- **Authorized official phone:** (360) 466-3900

## Contact information

- **Practice address:** 17395 RESERVATION RD, LA CONNER, WA 98257-8802
- **Practice address phone:** (360) 466-3900
- **Mailing address:** PO BOX 332, LA CONNER, WA 98257-0332
- **Mailing address phone:** (360) 466-3900

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251K00000X | Public Health or Welfare Agency | NC6498 | NC | Yes |
| 305S00000X | Point of Service | NC6498 | NC | — |

## Other

- **Enumeration date:** 05/13/2008
- **Last updated:** 05/13/2008