# BADGER MOUNTAIN DENTAL, LLC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

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

## Provider details

- **NPI number:** 1770973133
- **Authorized official:** LAWRENCE BRAITHWAITE D.M.D (OWNER/DENTIST)
- **Authorized official phone:** (509) 578-1200

## Contact information

- **Practice address:** 482 KEENE RD., RICHLAND, WA 99352
- **Practice address phone:** (509) 578-1200
- **Mailing address:** 482 KEENE RD, RICHLAND, WA 99352
- **Mailing address phone:** (509) 578-1200

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | DE 00011018 | WA | Yes |

## Other

- **Enumeration date:** 01/23/2015
- **Last updated:** 04/23/2015