# COLUMBIA EBJ LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Excel Dental
- **Organization subpart:** No

## Provider details

- **NPI number:** 1821456419
- **Authorized official:** DR. ELLIS BURKE JARDINE DMD (OWNER)
- **Authorized official phone:** (480) 862-3185

## Contact information

- **Practice address:** 1401 NW 1ST ST, BATTLE GROUND, WA 98604-4540
- **Practice address phone:** (360) 666-5700
- **Practice address fax:** (360) 666-5701
- **Mailing address:** 1401 NW 1ST ST, BATTLE GROUND, WA 98604-4540
- **Mailing address phone:** (360) 666-5700
- **Mailing address fax:** (360) 666-5701

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | — | WA | — |
| 1223P0700X | Prosthodontics | — | WA | Yes |

## Other

- **Enumeration date:** 02/10/2016
- **Last updated:** 03/07/2023