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Organization
DR. MILLGARD
Active
Organization
DR. MILLGARD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. THEODORE ROGER MILLGARD D.D.S. (DENTIST)
(509) 526-9742
Entity
Organization
Contact information
Practice address
270 E MAIN ST, DAYTON, WA 99328-1353
(509) 526-9742
Mailing address
270 E MAIN ST, DAYTON, WA 99328-1353
(509) 526-9742
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
DH 00005586
WA
261QD0000X
Dental Clinic/Center
H5723
OR
Other
Enumeration date
10/05/2009
Last updated
10/05/2009
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