# BRUCE C TOILLION

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Medical Lake Dental
- **Organization subpart:** No

## Provider details

- **NPI number:** 1497077986
- **Authorized official:** BRUCE C TOILLION DDS (OWNER/DDS)
- **Authorized official phone:** (509) 299-5171

## Contact information

- **Practice address:** N 123 BROWER, MEDICAL LAKE, WA 99022
- **Practice address phone:** (509) 299-5171
- **Practice address fax:** (509) 299-5151
- **Mailing address:** PO BOX 10, MEDICAL LAKE, WA 99022-0010
- **Mailing address phone:** (509) 299-5171
- **Mailing address fax:** (509) 299-5151

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | 4735 | WA | Yes |

## Other

- **Enumeration date:** 02/24/2010
- **Last updated:** 02/24/2010

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 5511704 | — | WA |