Individual
DR. ETHAN SHAGAR KAUFMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
1230 7TH AVE, LONGVIEW, WA 98632-3166
(360) 575-4801
Mailing address
1632 24TH AVE, LONGVIEW, WA 98632-3624
(360) 423-6611
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DE00008840
WA
Other
Enumeration date
08/03/2006
Last updated
07/08/2007
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