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Organization
SOUTH BEACH DENTAL CLINIC
Active
Organization
SOUTH BEACH DENTAL CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DUANE W PEGG DMD (PRESIDENT)
(360) 268-6225
Entity
Organization
Contact information
Practice address
509 S MONTESANO ST, WESTPORT, WA 98595
(360) 268-6225
(360) 268-6095
Mailing address
PO BOX 2049, WESTPORT, WA 98595-2049
(360) 268-6225
(360) 268-6095
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DE008350
WA
Other
Enumeration date
03/16/2017
Last updated
03/16/2017
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