Organization
BELLE VISTA DENTURE CLINIC, PLLC
Active
Other names
Bella Vista Denture Clinic, PLLC
Organization subpart
No
Provider details
NPI number
Authorized official
JOSHUA D BROOKS (SOLE MEMBER)
(509) 786-2963
Entity
Organization
Contact information
Practice address
3609 W NOB HILL BLVD, SUITE 103, YAKIMA, WA 98902-4744
(509) 786-2963
(888) 656-9322
Mailing address
1225 MEADE AVE, PROSSER, WA 99350-1423
(509) 786-2963
(888) 656-9322
Taxonomy
Speciality
Code
Description
License number
State
122400000X
Denturist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5049218
—
WA
Enumeration date
08/19/2007
Last updated
08/19/2007
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