Organization
KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST
Active
Parent organization
KAISER PERMANENTE DENTAL CARE PROGRAM
Other names
Longview-Kelso Dental Office
Organization subpart
Yes
Provider details
NPI number
Legal business name
KAISER PERMANENTE DENTAL CARE PROGRAM
Authorized official
MR. KENNETH R WRIGHT (VP DENTAL CARE SERVICES)
(503) 813-4660
Entity
Organization
Contact information
Practice address
1230 7TH AVE, LONGVIEW, WA 98632-3166
(800) 813-2000
(503) 286-6879
Mailing address
500 NE MULTNOMAH ST, PORTLAND, OR 97232-2023
(800) 813-2000
(503) 286-6879
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
11/04/2016
Last updated
06/01/2021
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