Organization
KAMILCHE DENTAL CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. STEVEN R PETERS LISCENSED DENTURIST (OWNER)
(360) 427-1784
Entity
Organization
Contact information
Practice address
3100 SE OLD OLYMPIC HWY, SHELTON, WA 98584-7731
(360) 427-1784
(360) 427-1818
Mailing address
3100 SE OLD OLYMPIC HWY, SHELTON, WA 98584-7731
(360) 427-1784
(360) 427-1818
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DE00008865
WA
122400000X
Denturist
DN00000236
WA
122400000X
Denturist
DN0000036
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5040365
—
WA
Enumeration date
12/08/2006
Last updated
08/07/2012
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