# VANCOUVER DENTAL LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Colombia River Dentistry
- **Organization subpart:** No

## Provider details

- **NPI number:** 1245011634
- **Authorized official:** CLARK BRINTON (OWNER)
- **Authorized official phone:** (505) 273-4994

## Contact information

- **Practice address:** 16600 SE 15TH ST, VANCOUVER, WA 98683-9501
- **Practice address phone:** (360) 878-7435
- **Mailing address:** 16600 SE 15TH ST, VANCOUVER, WA 98683-9501

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QD0000X | Dental Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 10/11/2023
- **Last updated:** 10/11/2023