# MOUNTAIN VISTA DENTAL

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

## Provider details

- **NPI number:** 1861899957
- **Authorized official:** RUTH G KOSMASKI DDS (OWNER)
- **Authorized official phone:** (509) 493-2244

## Contact information

- **Practice address:** 640 N MAIN AVE, WHITE SALMON, WA 98672-8751
- **Practice address phone:** (509) 493-2244
- **Practice address fax:** (509) 493-2242
- **Mailing address:** 640 N MAIN AVE, P.O. BOX 491, WHITE SALMON, WA 98672-8751
- **Mailing address phone:** (509) 493-2244
- **Mailing address fax:** (509) 493-2242

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | DE 00010839 | WA | Yes |

## Other

- **Enumeration date:** 12/04/2014
- **Last updated:** 12/04/2014