# SOUTHSIDE DENTAL CARE, INC. P.S.

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

## Provider details

- **NPI number:** 1609995927
- **Authorized official:** DR. DONALD THOMAS WALTERS DDS (PRESIDENT)
- **Authorized official phone:** (360) 752-9000

## Contact information

- **Practice address:** 1215 OLD FAIRHAVEN PKWY, SUITE \#A, BELLINGHAM, WA 98225-7444
- **Practice address phone:** (360) 752-9000
- **Practice address fax:** (360) 752-9846
- **Mailing address:** 1215 OLD FAIRHAVEN PKWY, SUITE \#A, BELLINGHAM, WA 98225-7444
- **Mailing address phone:** (360) 752-9000
- **Mailing address fax:** (360) 752-9846

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | 7450 | WA | Yes |

## Other

- **Enumeration date:** 03/28/2007
- **Last updated:** 08/22/2020