# SWINOMISH UPPER SKAGIT DENTAL

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Swinomish Tribal Community
- **Organization subpart:** No

## Provider details

- **NPI number:** 1922203405
- **Authorized official:** RAYMOND A DAILEY DDS (DENTIST)
- **Authorized official phone:** (360) 466-3900

## Contact information

- **Practice address:** 17395 RESERVATION RD, LA CONNER, WA 98257-8802
- **Practice address phone:** (360) 466-3900
- **Practice address fax:** (360) 466-7301
- **Mailing address:** PO BOX 332, LA CONNER, WA 98257-0332
- **Mailing address phone:** (360) 466-3900
- **Mailing address fax:** (360) 466-7301

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | 6498 | NC | Yes |

## Other

- **Enumeration date:** 06/15/2007
- **Last updated:** 08/20/2007

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 5039490 | — | WA |