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Organization
CONDON DENTAL SERVICES
Active
Organization
CONDON DENTAL SERVICES
Active
Parent organization
CONDON DENTAL SERVICES, PS
Other names
Odessa Dental Clinic
Organization subpart
Yes
Provider details
NPI number
Legal business name
CONDON DENTAL SERVICES, PS
Authorized official
MICHAEL P CONDON DR (OWNER)
(509) 982-2605
Entity
Organization
Contact information
Practice address
20 W 1ST, ODESSA, WA 99159-0459
(509) 982-2605
(509) 982-9951
Mailing address
PO BOX 429, 20 W FIRST, ODESSA, WA 99159-0429
(509) 982-2605
(509) 982-9951
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
8440
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5054358
—
WA
Enumeration date
05/24/2006
Last updated
11/02/2012
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