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Organization
PENINSULA COMMUNITY HEALTH SERVICES
Active
Organization
PENINSULA COMMUNITY HEALTH SERVICES
Active
Other names
Peninsula Community Health Services- Family Dental
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER KREIDLER-MOSS (CEO)
(360) 377-3776
Entity
Organization
Contact information
Practice address
3102 WHEATON WAY, BREMERTON, WA 98310-3437
(360) 377-3776
Mailing address
PO BOX 960, BREMERTON, WA 98337-0212
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
NULL
1223G0001X
General Practice Dentistry
Primary
—
—
261QF0400X
Federally Qualified Health Center (FQHC)
—
NULL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
NPI
—
WA
Enumeration date
03/09/2023
Last updated
06/03/2026
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