# DENTAL PROFESSIONALS OF WASHINGTON QUIRT MONGRAIN GIBREE PC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** DENTAL PROFESSIONALS OF WASHINGTON, QUIRT, MONGRAIN, GIBREE, PC
- **Other names:** Bickford Family Dental Care
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1174192231
- **Legal business name:** DENTAL PROFESSIONALS OF WASHINGTON, QUIRT, MONGRAIN, GIBREE, PC
- **Authorized official:** TABATHA LEMKE (CREDENTIALING COORDINATOR)
- **Authorized official phone:** (217) 540-6078

## Contact information

- **Practice address:** 2709 BICKFORD AVE STE A, SNOHOMISH, WA 98290-1766
- **Practice address phone:** (425) 374-8451
- **Mailing address:** 2709 BICKFORD AVE STE A, SNOHOMISH, WA 98290-1766
- **Mailing address phone:** (425) 374-8451

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | — | — | Yes |

## Other

- **Enumeration date:** 06/23/2021
- **Last updated:** 06/23/2021