# IMHOLTE & ANDERSON PLLC

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

## Provider details

- **NPI number:** 1942318829
- **Authorized official:** PENNIE LYN BROYLES (OFFICE MANAGER)
- **Authorized official phone:** (360) 577-1153

## Contact information

- **Practice address:** 409 WEST MAIN STREET, KELSO, WA 98626
- **Practice address phone:** (360) 577-1153
- **Practice address fax:** (360) 425-1540
- **Mailing address:** 409 WEST MAIN STREET, KELSO, WA 98626
- **Mailing address phone:** (360) 577-1153
- **Mailing address fax:** (360) 425-1540

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | 4754 | WA | Yes |
| 1223G0001X | General Practice Dentistry | 8788 | WA | — |

## Other

- **Enumeration date:** 08/29/2006
- **Last updated:** 08/22/2020