Organization
CUSTOM DENTURES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CAMERON L. FETTIG (BUSINESS MANAGER)
(360) 883-9888
Entity
Organization
Contact information
Practice address
13720 NE 28TH ST, #B, VANCOUVER, WA 98682-8048
(360) 883-9888
(360) 883-9909
Mailing address
13720 NE 28TH ST, #B, VANCOUVER, WA 98682-8048
(360) 883-9888
(360) 883-9909
Taxonomy
Speciality
Code
Description
License number
State
122400000X
Denturist
Primary
DN00000393
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5047576
—
WA
Enumeration date
09/19/2008
Last updated
09/19/2008
About Stedi
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