# SEDRO WOOLLEY FAMILY DENTAL CENTER, P.S.

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

## Provider details

- **NPI number:** 1184963845
- **Authorized official:** DR. HANSROLF H GRUENER D.D.S. (OWNER)
- **Authorized official phone:** (360) 855-0351

## Contact information

- **Practice address:** 830 METCALF ST, SEDRO WOOLLEY, WA 98284-1423
- **Practice address phone:** (360) 855-0351
- **Practice address fax:** (360) 855-9357
- **Mailing address:** 830 METCALF ST, SEDRO WOOLLEY, WA 98284-1423
- **Mailing address phone:** (360) 855-0351
- **Mailing address fax:** (360) 855-9357

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QD0000X | Dental Clinic/Center | 603264506 | WA | Yes |

## Other

- **Enumeration date:** 01/31/2013
- **Last updated:** 01/31/2013