# DR. MILLGARD

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

## Provider details

- **NPI number:** 1255666467
- **Authorized official:** DR. THEODORE ROGER MILLGARD D.D.S. (DENTIST)
- **Authorized official phone:** (509) 526-9742

## Contact information

- **Practice address:** 270 E MAIN ST, DAYTON, WA 99328-1353
- **Practice address phone:** (509) 526-9742
- **Mailing address:** 270 E MAIN ST, DAYTON, WA 99328-1353
- **Mailing address phone:** (509) 526-9742

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QD0000X | Dental Clinic/Center | DH 00005586 | WA | Yes |
| 261QD0000X | Dental Clinic/Center | H5723 | OR | — |

## Other

- **Enumeration date:** 10/05/2009
- **Last updated:** 10/05/2009