# DENTAL PROFESSIONALS OF WASHINGTON QUIRT MONGRAIN GIBREE PC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** HEARTLAND DENTAL
- **Other names:** Chehalis Dental Care
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1316564925
- **Legal business name:** HEARTLAND DENTAL
- **Authorized official:** TABATHA LEMKE (CREDENTIALING COORDINATOR)
- **Authorized official phone:** (217) 540-6078

## Contact information

- **Practice address:** 68 SW 13TH ST, CHEHALIS, WA 98532-3627
- **Practice address phone:** (360) 748-1833
- **Mailing address:** 68 SW 13TH ST, CHEHALIS, WA 98532-3627

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | — | — | Yes |

## Other

- **Enumeration date:** 06/30/2020
- **Last updated:** 06/30/2020