Organization
GUNDERSEN DENTAL, PLLC
Active
Other names
Tyler B. Gundersen, PLLC
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TYLER BURTON GUNDERSEN D.D.S. (OWNER)
(509) 663-4436
Entity
Organization
Contact information
Practice address
251 N. CHELAN AVE, WENATCHEE, WA 98801
(509) 663-4436
(509) 663-5974
Mailing address
251 N. CHELAN AVE, WENATCHEE, WA 98801
(509) 663-4436
(509) 663-5974
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
261QD0000X
Dental Clinic/Center
DE00010222
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5048871
—
WA
Enumeration date
08/03/2016
Last updated
03/09/2020
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