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Organization
HALF DENTAL WA
Active
Organization
HALF DENTAL WA
Active
Other names
Half Dental
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. TERESA L RENNELS (OFFICE MANAGER)
(360) 694-4253
Entity
Organization
Contact information
Practice address
910 NE MINNEHAHA ST, SUITE 12, VANCOUVER, WA 98665-8750
(360) 694-4253
(360) 695-3589
Mailing address
910 NE MINNEHAHA, SUITE 12, VANCOUVER, WA 98665
(360) 694-4253
(360) 695-3589
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DE60096080
WA
Other
Enumeration date
08/08/2012
Last updated
08/08/2012
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