# NISQUALLY REACH FAMILY DENTISTRY

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

## Provider details

- **NPI number:** 1215584701
- **Authorized official:** CARRIE GARNER (EXECUTIVE ADMIN.)
- **Authorized official phone:** (360) 458-5606

## Contact information

- **Practice address:** 2521 MARVIN RD NE STE G, LACEY, WA 98516-3153
- **Practice address phone:** (360) 458-5606
- **Mailing address:** 2521 MARVIN RD NE STE G, LACEY, WA 98516-3153

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | — | NULL | Yes |
| 122300000X | Dentist | — | — | Yes |

## Other

- **Enumeration date:** 08/20/2019
- **Last updated:** 08/20/2019