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Organization
THREE RIVERS DENTAL LLC
Active
Organization
THREE RIVERS DENTAL LLC
Active
Other names
Three Rivers Dental
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JARED DOMAN (OWNER)
(360) 601-9454
Entity
Organization
Contact information
Practice address
620 TRIANGLE SHOPPING CTR STE 660, LONGVIEW, WA 98632-4690
(360) 803-8003
Mailing address
633 NW 164TH ST, RIDGEFIELD, WA 98642-9478
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
NULL
Other
Enumeration date
02/07/2023
Last updated
02/07/2023
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