# NORTHWEST CENTER FOR PROSTHODONTICS

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Olympia Smile Design
- **Organization subpart:** No

## Provider details

- **NPI number:** 1548779515
- **Authorized official:** JOSHUA A MANCHESTER DDS, MSD (DENTIST)
- **Authorized official phone:** (406) 599-4642

## Contact information

- **Practice address:** 3425 ENSIGN RD NE STE 210, OLYMPIA, WA 98506-5063
- **Practice address phone:** (406) 599-4642
- **Mailing address:** 3425 ENSIGN RD NE STE 210, OLYMPIA, WA 98506-5063
- **Mailing address phone:** (406) 599-4642

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223P0700X | Prosthodontics | DE60579609 | WA | Yes |

## Other

- **Enumeration date:** 09/22/2017
- **Last updated:** 07/21/2022