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Organization
BADGER MOUNTAIN DENTAL, LLC
Active
Organization
BADGER MOUNTAIN DENTAL, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LAWRENCE BRAITHWAITE D.M.D (OWNER/DENTIST)
(509) 578-1200
Entity
Organization
Contact information
Practice address
482 KEENE RD., RICHLAND, WA 99352
(509) 578-1200
Mailing address
482 KEENE RD, RICHLAND, WA 99352
(509) 578-1200
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DE 00011018
WA
Other
Enumeration date
01/23/2015
Last updated
04/23/2015
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