# WEST PASCO FAMILY DENTAL LLC

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

## Provider details

- **NPI number:** 1447380233
- **Authorized official:** DR. GREG W FRODEL DDS (DENTIST)
- **Authorized official phone:** (509) 547-9955

## Contact information

- **Practice address:** 5204 N ROAD 68, SUITE B, PASCO, WA 99301-9275
- **Practice address phone:** (509) 547-9955
- **Practice address fax:** (509) 544-2827
- **Mailing address:** 5204 N ROAD 68, SUITE B, PASCO, WA 99301-9275
- **Mailing address phone:** (509) 547-9955
- **Mailing address fax:** (509) 544-2827

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | 5567 | WA | Yes |

## Other

- **Enumeration date:** 03/07/2007
- **Last updated:** 01/22/2009

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 5050190 | — | WA |