# DENTAL PROFESSIONALS OF WASHINGTON QUIRT MONGRAIN GIBREE PC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** DENTAL PROFESSIONALS OF WASHINGTON QUIRT MONGRAIN GIBREE PC
- **Other names:** Dental Care of Edmonds
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1760033807
- **Legal business name:** DENTAL PROFESSIONALS OF WASHINGTON QUIRT MONGRAIN GIBREE PC
- **Authorized official:** TABATHA LEMKE (CREDENTIALING COORDINATOR)
- **Authorized official phone:** (217) 540-6078

## Contact information

- **Practice address:** 23805 HIGHWAY 99 STE 100, EDMONDS, WA 98026-9204
- **Practice address phone:** (425) 778-6333
- **Mailing address:** 23805 HIGHWAY 99 STE 100, EDMONDS, WA 98026-9204

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | — | NULL | Yes |
| 1223G0001X | General Practice Dentistry | — | — | Yes |

## Other

- **Enumeration date:** 09/20/2019
- **Last updated:** 11/20/2020